response essay of roughly 250-500 words

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cont._issues_in_bioethics_response__4--345-394.pdf.pdf

344 R E

P R

O D

U C

T IO

N

N or need the peison believe that only perfect individu-

als ought to exist A n individual can lationally decide

to abort a fetus w ith a genetic defect w

hile nevertheless b e lie

vin g th

a t p

e lso

n s w

ith d

lsa b ih

tie s a

re o

f e q u a l

w orth if he believes that fetuses (or at least fetuses up

to and including the stage at w hich the abortion is pel-

foim ed) are not persons and hence do not have the

rights and equal m oial status of pelsons

T o believe that it is pelm

lsslble to avoid a serious dlsabihty by selective abom

on one need not beheve that Individuals w

ith that disability ought not to be born A

ll that is necessary is the belief that the fetus h a s n

o rig

h t to

b e b

o rn

F u rth

e rm

o re

, o n e ca

n --a

n d

m any people appatently do--consistently believe both

that fetuses, w hethei they w

ill have disabilities or not, have no right to be born (because they are not per- sons) w

hile believing that all persons, including those w

ith d

lsa b lh

tie s, h

a ve

a lig

h t to

e xist, a

n d h

e n ce

a nght not to be killed, because they are peisons

S im

ilarly, there is nothing inconsistent O l m

otlva- tio

n a lly in

co h e re

n t a

b o u t b

e lie

vin g th

a t o

n e o

u g h t

not bllng a disabled child into the w orld and believ-

in g th

a t it is n

o t th

e ca

se th

a t in

d ivid

u a ls w

ith d

is- abilities ought not to be boln. (S

om eone can believe

that she ought not to m arry w

ithout believing that m

aiilages ought not to occur.) P

erhaps those w ho advance the expresslvlst algu-

m e n t w

ill still n o t b

e co

n vin

ce d o

f o u r re

b u tta

l. T h e

appeal of the argum ent is its sim

phclty Thus a peison w

h o h

e rse

lf h a s a

d isa

b ility, im

p a tie

n t w

ith th

e su

b -

tleties and halr-sphttm g of the plecedlng argum

ents, m

ight leply:

tlve, w e are com

m itted to the judgm

ent that m the

the w orld should not include so m

any disabilities and !ÿ hence so m

any individuals w ith dlsabilitm

s. B ut it is not

the people w ith the dlsabllitm

s that w e devalue, it is the

dIsablhtm s them

selves W e do not w

ish to reduce the num

ber of people w ith disabilities by taking the life of

any individual w ho has a disability.

D e

va lu

m g

D tsa

b th

tie s, N

o t P

e o

p le

w ith

D isa

b ilitie

s W

e devalue dlsabllm es because w

e value the oppoltu- nItles and w

elfale of the people w ho have them

A nd

it IS because w

e value people, all people, that w e care

about lim itations on theal w

elfare and oppoxtunihes. W

e also know that dlsabxhtles as such dim

im sh oppor-

tunities and w elfaae, even w

hen they ale not so severn that the lives of those w

ho have them am

not w orth

livin g , a

n d e

ve n if th

o se

in d ivid

u a ls d

o n

o t h

tm a lly

su ffe

r a s a

le su

lt o f th

e ir d

isa b

lh tie

s. T h

u s th

e m

is nothing m

atlonal, m otivatlonally Incoherent, or disin-

genuous in saying that w e devalue the disabilities and

w ish to ieduce theil incidence w

hile valuing existing pm

sons w ith dlsabilm

es, and that w e value them

the sam

e as those w ho do not have disablhties.

M oieovei, even if It w

ele assum ed that fetuses are

persons and that hence kllhng them to leduce the inci-

dence of disabilities is m orally indlstingm

shable from extm

im natm

g & sabled chlldien and adults, this w

ould

h a

ve n

o n

e g

a tive

im p

lica tio

n s fo

i th e

o th

e r th

re e

m o

d e

s o f g

e n

e tic ln

te lve

n tlo

n to

a vo

id d

isa b

lh tIe

s N

one of these involves killing a fetus, so none can be descilbed as kllhng a peison, even if w

e assum e that

fetuses ale pm sons T

herefore endoism g these m

odes of reducing disabilities need not expiess and does not

presuppose the judgm ent that existing individuals w

ith disabihtles have no right to hve

T o lepeat A

dvocating the foulth m ode of interven-

tion (selective aboltlon) is tantam ount to saying that

people hke you (w ho have disabilities) have no right

to e

xist o n

ly o n

th e

h ig

h ly co

n tio

ve isla

l a ssu

m p

tio n

that fetuses are pelsons O pting for the first, second,

and thnd m odes of intervention has no im

plications at a ll fo

r th e w

o lth

in e ss o

r u n w

o rth

in e ss o

f "& sa

b le

d lives," legm

dless of w hich vm

w of the m

oral status of fetuses is conect W

hat appeared to be a distinctive

objection to a new technology turns out to be a fam

ll- im

objection to the age-old practice of aboitlon. N

one of this is to deny that som e m

em bers of the

disabihtles com m

um ty m

e genuinely offended by w hat

they take to be the m isplaced zeal to harness the pow

ers of science to pievent disabihtIes G

ranted the sham eful

hlstoly of dlscrinunatlon against and insensltiV W

tow ard

p e rso

n s w

ith d

isa b ilitie

s, th e u ta

kin g o

ffe n se

is p e i-

fectly understandable H ow

ever, it is one thing to say that certm

n behavIol is offensive to a partlculm group,

and qm te anothei to say that the fact that the group is

offended constitutes a violation of anyone's nghts. In geneial, a hbeial som

ety cannot count the occm -

rence of offense, as distinct from rights violations, as a

sufficient glound for cm talllng liberty, w

hether it is the hbelty of a pelson to choose a surgical proceduIe that w

ill cure her ow n paraplegia O

l that of her child, or the llbm

ty of a researchel to tiy to develop a techm que for

preventing a genetically based im pairm

ent

S um

m a13, of R

esponse to E xptessivtst O

bJection It m

a y b

e u

se fu

l a t th

ÿs p o

in t to

su m

m a

rize th

e m

a re

points of our com plex discussion of the explessivist

aIgum ent against genetic intelventlon T

o be sound, the argum

ent eathel m ust show

that it is m otivation-

ally im possible or m

ational both to devalue and seek to

a vo

id d

lsa b

lh tm

s w h

ile a

t th e

sa m

e tim

e va

lu in

g equally individuals w

ho have dlsabahtaes or it m ust

defend the view that fetuses am

persons, w ith all the

lghts that pelsons have, and that avoiding disabditm s

by abol tm g fetuses w

ith disabihtles is the m oxal equiv-

alent of reducing the incidence of disabilities by exter- m

inating disabled chil& en and adults

T h

e first a

lte in

a tlve

is u n

co n

vin cin

g . T

h e

ie a

re m

a n

y in sta

n ce

s in w

h ich

w e

d e

va lu

e (a

n d

se e

k to a

vo id

) ce lta

m ch

a la

cte rista

cs th a

t so m

e in

d ivid

u a

ls h

a ve

w ith

o u

t d e

va lm

n g

in d

ivid u

a ls w

h o

h a

ve th

e m

. T

h e

se co

n d

a lte

rn a

tive co

m e

s a t a

ste e

p p

rice N

o t

o n ly m

u st th

e d

isa b lh

tie s rig

h ts a

d vo

ca te

a m

cu la

te and defend an account of pm

sonhood that show s that

fetuses ale pm sons, he m

ust also acknow ledge that

the fundam ental m

ror of those w ho advocate selective

abortion to avoid dlsabilitm s is not that they devalue

in d

ivid u

a ls w

ith d

isa b

ilitie s b

u t th

a t th

e y fa

ll to recognize that fetuses, w

hether disabled ol not, are pm

sons. T he aIgum

ent, then, w ould have nothing to

do w ith disabilities as such

R ecall, how

ever, that to say that it is perrm ssible to

avoid dlsabihtles by genetic Interventions is not to say that w

e ought to seduce the incidence of dlsabihties, m

uch less that disabled pelsons ought not to exist .... [W

e] have aigued [elsew hele] that there can be obhga-

tions of justice, as w ell as obligations to w

event harm ,

that iequne genetic intelventlons F rom

this ÿm sD

ec-

N o analysis of the possible m

otives O l of the coherence of

the possible ieasons for pleventm g &

sablhtles can erase one sH

nple fact W hen you endorse the use of genetlc science to

pievent dÿsablllhes, you ate saying that people hke m e ought

not to exist A nd w

hen you say that people hke m e ought

n o

t to e

xist, yo u

d e

va lu

e m

e In

th e

m o

st fu n

d a

m e

n ta

l a n

d thieatenlng w

ay Im aginable Y

oui conceptm n of the value

of hum an hfe denm

s that m y hfe, im

perfect as it is m youl

eyes, has value

The Problem of Justifying Abortion

D O

N M

A R

Q U

IS

W hy A

bortion Is Im m

oral

D onald M

arqm s, professor of philosophy at the U

m verslty of K

ansas, has m ain-

tam ed acm

, e interests in the history of ethics as w ell as problem

s of aboruon, social ethics, and research ethm

s R epresentative publications include "Leaÿ,m

g T

h e ra

p y to

C h a n ce

A n h

n p a sse

m th

e E

th ics o

f R a n d o lm

ze d C

h n ica

l T ria

ls," T

he H astings C

ente) R e])ott, "A

n E thm

al P roblem

C onceInIng R

ecent T herapeutic

R esearch on B

reast C ancer," H

ypatÿa, and "F oul" V

ersions of D ouble E

ffect," The Jouÿ hal of M

e&cm e and Phdosophy

T he vm

w that abortion is, w

ith iare exceptions, seri- ously im

m olal has iecelved little suppoIt in the xecent

philosophical htm ature. N

o doubt m ost phllosophm

s

From Journal of Phdosophy 86, no 4 (Apnt 1989), 183-202

F o o tn

o te

s m n u m

b e re

d

affihated w ith secular restitutions of hlghel education

believe that the anti-aboitlon position ts elthm a sym

p- tom

of irrational lehglous dogm a ol a conclusion gen-

erated by seriously confused philosophical argum ent.

T he purpose of this essay is to undelm

m e this genelal

belief. T his essay sets out an algum

ent that purpoits

J+ -l-ÿ Jtx.Jlÿg X

\'ÿ'Lt tJ ÿ I IÿIN

to show , as w

ell as any argum ent in ethics can show

, that abortion is, except possibly In Iare cases, sei1- o u sly Im

m o ra

l, th a t it is In

th e sa

m e m

o ra

l ca te

g o ly

as killing an Innocent adult hum an being.

T h e a

rg u m

e n t is b

a se

d o

n a

m a jo

I a ssu

m p tio

n .

M any of the m

ost Insightful and caieful w ritels on the

e th

ics o f a

b o rtio

n . . b

e lie

ve th

a t w

h e th

e i o

r n o t

a b o rtio

n is m

o la

lly p e tm

Issib le

sta n d s o

1 " fa

lls o n

w hether ol not a fetus IS

the sort of being w hose life

It is se iio

u sly w

ro n g to

e n d T

h e a

rg u m

e n t o

f th is

essay w ill assum

e, but not argue, that they are correct. A

lso, this essay w ill neglect Issues of great im

por- tance to a com

plete ethics of aboation S om

e antiaboi- tlo

m sts w

ill a llo

w th

a t ce

rta in

a b

o itlo

n s, su

ch a

s aboltlon before Im

plantation or aboltion w hen the life

of a w om

an is threatened by a pIegnancy oi abortion a fte

r la p e , m

a y b

e m

o ra

lly p e lm

a sslb

le T

h is e

ssa y

w all not exploie the casuistry of these hard cases. T

he purpose of this essay IS

to develop a general argum ent

for the claim that the overw

helm ing m

ajority of delib- erate aboltions ale seriously Im

m oral .

I P

assions in the aboition debate m n high. T

here are both plauslblhtles and difficulties w

ith the standard positions A

ccordingly, it is haldly sm pnsm

g that pam

sans of either side em brace w

ith fervor the m oral

g e n e ra

h za

tlo n s th

a t su

p p o it th

e co

n clu

sio n s th

e y

pleanalytlcally favor, and reject w ith disdain the

m o ra

l g e n e ra

liza tio

n s o

f th e u o

p p o n e n ts a

s b e in

g subject to Inescapable difficulties. It as easy to beheve that the counterexam

ples to one's ow n m

oral pnncl- ples are m

erely tem poraiy difficulties that w

all dis- so

lve in

th e

w a

ke o

f fm th

e l p

h d

o so

p h

lca l le

se a

rch ,

a n d th

a t th

e co

u n te

re xa

m p le

s to th

e p

rin cip

le s o

f o n e 's o

p p o n e n ts a

ie a

s stra lg

h tfo

iw a rd

a s th

e co

n -

tra d

ictio n b

e tw

e e

n A

a n

d O

p Io

p o sitio

n s m

tIa d

l- tIo

n a

l lo g

ic T h

is m ig

h t su

g g

e st to

a n

lm p

a m

a l

observe1 (if thele are any) that the aboltion issue is unIesolvable

T here is a w

ay out of this apparent dialectical quandm

y The m oial generalizations of both redes are

n o t q

u ite

co rre

ct T h e g

e n e la

liza tio

n s h

o ld

fo r th

e m

ost pait, for the usual cases. T his suggests that they

a re

a ll a

ccid e

n ta

l g e

n e

ra liza

tio n

s, th a

t th e

m o

ra l

claim s m

ade by those on both redes of the dispute do not touch on the essence of the m

atter T

his use of the dIstm ctm

n betw een essence and

accident is not m eant to Invoke obscm

e m etaphysical

ca te

g o rie

s. R a th

e r, it is in

te n d e d to

re fle

ct th e rÿ

atheoretical nature of the aboItion discussion. If the? generalization a pat tisan In the aborhon dispute adopts w

ere derived from the reason w

hy ending the life of a h

u m

a n b

e in

g IS

w ro

n g , th

e n th

e le

co u ld

n o t b

e exceptions to that geneiahzation unless som

e special case obtains in w

hich there are even m ore pow

erful countervailing reasons S

uch generalizations W ould

not be m elely accidental generalizations; they W

ould point to, or be based upon, the essence of the w

rong, ness of killing, w

hat it is that m akes kllhng w

rong. A

ll this suggests that a necessary condition of resolv- in

g th

e a

b o

rtio n

co n

tro ve

rsy is a m

o re

th e

o re

tica l

account of the w Iongness of killing A

ftel all, if w e

m erely beheve, but do not understand, w

hy killing adult hum

an beings such as om selves is w

rong, how co

u ld

w e co

n ce

iva b ly sh

o w

th a t a

b o ltio

n is e

ith e r

im m

olal or perm issible9

II In oider to develop such an account, w

e can stair from the follow

ing unproblem atlc assum

phon concerning our ow

n case: It is w rong to kill us W

hy as it w long?

S om

e answ ers can be easily elim

inated. It m ight be

said that w hat m

akes kllhng us w rong is that a killing

brutahzes the one w ho kills B

ut the brutahzation con- sJsts of being inuied to the perform

ance of an act that is hideously im

m oral; hence, the brutahzatlon does

not explain the lm m

orahty. It m ight be said that w

hat m

akes kilhng us w rong is the gleat loss others w

ould expeiaence due to our absence. A

lthough such hubris is u

n d

e lsta

n d

a b

le , su

ch a

n e

xp la

n a

tio n

d o

e s n

o t

account for the w rongness of killing herrm

ts, or those w

h o

se h

ve s a

re a

e la

tive ly in

d e

p e

n d

e n

t a n

d w

h o

se friends find ÿt easy to m

ake new friends.

A m

o le

o b w

o u s a

n sw

e J is b

e tte

r W h a t p

rim a rily

m a

ke s killin

g w

ro n

g is n

e lth

e l its e

ffe ct o

n th

e m

u i-

d e le

r n o a its e

ffe ct o

n th

e vich

m 's frie

n d s a

n d re

la -

tives, but its effect on the victim . T

he loss of one's life is one of the gieatest losses one can suffer. T

he loss of one's hfe deprives one of all the experiences, activ- ihes, plojects, and enjoym

ents that w ould otherw

ise have constituted one's future. T

herefore, killing som e-

o n e is w

ro n g , p

n m

a rily b

e ca

u se

th e killin

g in

flicts (one of) the greatest possible losses on the victim

. T o

describe this as the loss of life can be m isleading,

how evel The change in m

y biological state does not by itself m

ake killing m e w

rong The effect of the loss of m

y biological hfe is the loss to m e of all those

a ctivm

e s, p

ro je

cts, e xp

e rie

n ce

s, a n

d e

n jo

ym e

n ts

w h

a ch

w o

u ld

o th

e lw

ise h

a ve

co n

stitu te

d m

y fu tu

re

n a l life

T h e s e a

c tiv

itie s , p

ro je

c tÿ

, e x p ÿ L ÿ n ÿ ,,ÿ

,

ld enjoym ents aIe etther valuable foI their ow

n sakes are m

eans to som ething else that is valuable for its

sake. S om

e parts of m y futuie aie not valued by

now , but w

ill com e to be valued by m

e as I giow and as m

y values and capactties change. W hen

I am killed, I am

depIlved both of w hat I now

value w

h ich

w o

u ld

h a

ve b

e e

n p

a rt o

f m y fu

tu le

p e

rso n

a l

life, but also w hat I w

ould com e to value T

heiefole, )" w

hen I die, I am deprived of all of the value of m

y [nture Inflicting this loss on m

e as ultim ately w

hat m

akes killing m e w

long. T his being the case, it w

ould seem

that w hat m

akes kilhng any adult hum an being

prim a facie seriously w

iong is the loss of his oI hm futule.

H o

w sh

o u

ld th

is ru d

im e

n ta

ry th e

o ry o

f th e

w rongness of kdhng be evaluated? It cannot be

fa u lte

d fo

i d e

iivm g a

n "o

u g h

t" fro m

a n "is," fo

r a t

d o e s n

o t. T

h e a

n a lysis a

ssu m

e s th

a t kd

h n g m

e (o

r yo

u , le

a d e r) is p

rim a fa

cle se

rio u sly w

ro n g T

h e

point of the analysts is to estabhsh w hich natural

propelty ultim ately explains the w

longness of the kilhng, given that it is w

rong A natm

al property w

all ultim ately explain the w

rongness of kilhng, only ff (1) the explanation fits w

ith our intuitions about the m

atte1 and (2) there is no other natural p ro

p e Ity th

a t p

ro vid

e s th

e b

a sis fo

x a b

e tte

i e xp

la -

nation of the w longness of kilhng T

his analysis rests on the intuition that w

hat m akes kxlhng a par-

ticu la

I h u m

a n o

l a n im

a l w

ro n g is w

h a t it d

o e s to

that partm ular hum

an or anim al W

hat m akes kllhng

w io

n g

is so m

e n

a tu

ra l e

ffe ct o

l o th

e r o

f th e

killin g

S o m

e w

o u ld

d e n y th

is F

o I in

s ta

n c e , a

d iv

in e -

co m

m a n d th

e o rist in

e th

ics w o u ld

d e n y It. S

m e ly

this denial is, how ever, one of those featm

es of divine- com

m and theory w

hich lendeIs it so im plausible

T he claim

that w hat m

akes killing w long is the

loss of the victim 's future is directly suppolted by tw

o conm

deratm ns In the first place, this theoIy explains

w hy w

e legm d killing as one of the W

O lS

t of crim es.

K illing is especially w

iong, because it deprives the victim

o f m

o re

th a

n p

e lh

a p

s a n

y o th

e r crim

e . In

th e

second place, people w ith A

ID S

or cancer w ho know

they ate dying believe, of couxse, that dying is a very bad thing fol them

T hey beheve that the loss of a

future to them that they w

ould otherw ise have expe-

rienced xs w hat m

akes theil ptem ature death a veiy

bad thing for them . A

betteI theory of the w rongness

of killing w ould requile a diffeient natulal plopetty

associated w ith kilhng w

hich better fits w ith the atti-

tudes of the dying W hat could It be9

T he vtew

that w hat m

akes kÿlling w iong is the loss

to the victnn of the value of the victim 's futute gains

addttional suppoIt w hen som

e of its tm phcatm

ns aie e xa

m in

e d . In

th e filS

t p la

ce , It IS

in co

m p a tib

le w

ith th

e vie

w th

a t it is w

io n

g to

kill o n

ly b e

in g

s w h

o m

e b

io lo

g ica

lly h u

m a

n . It is p

o ssib

le th

a t th

e le

e xists a

diffelent species fiom anotheI planet w

hose m em

beis have a futuie hke ores S

ince having a futuIe like that xs w

h a

t m a

ke s kd

lin g

so m

e o

n e

w ro

n g

, th is th

e o

iy entails that it w

ould be w iong to kill m

em bers of such

a species H ence, this theoly is opposed to the clm

m that only life that IS

biologically hum an has great

m o

ia l w

o xth

, a cla

im w

h ich

m a

n y a

n ti-a

b o

ltm n

lsts h

a ve

se e

m e

d to

a d

o p

t T h

is o p

p o

sitio n

, w h

ich th

is th

e o ry h

a s in

co m

m o n w

ith p

e a so

n h o o d th

e o lxe

s, seem

s to be a m eiit of the theoly

In the second place, the claim that the loss of one's

fu tu

re is th

e w

io n

g -m

a kIn

g fe

a tu

ie o

f o n

e 's b

e in

g killed entails the possibility that the futuies of som

e a ctu

a l n

o n h u m

a n m

a m

m a ls o

n o

u r o

w n p

la n e t a

re sufficiently like ores that it is seriously w

iong to kill them

also W hether som

e am m

als do have the sam e

light to hfe as hum an beings depends on adding to the

a cco

u n

t o f th

e w

lo n

g n

e ss o

f killin g

so m

e a

d d

itm n

a l

account of just w hat it is about m

y futm e oi the futules

of othei adult hum an beings w

hich m akes ÿt w

rong to kdl us N

o such addltm nal account w

ill be offeIed m this essay U

ndoubtedly, the pm vlsm

n of such an account w

ould be a vely difficult m atte1 U

ndoubtedly, any such account w

ould be quite controvelsIal. H ence,

it sulely should not leflect badly on this sketch of an elem

entary theory of the w iongness of killing that it

is m d

e te

rm m

a te

w ith

ie sp

e ct to

so m

e ve

ry d ifficu

lt issues xegm

ding am m

al rights. In the thnd place, the claim

that the loss of one's future is the w

rong-m aking feature of one's being killed

does not entail, as sanctity of hum an life theoIies do,

th a t a

ctive e

u th

a n

a sia

is w lo

n g

P e

rso n s w

h o

a re

sevelely and incuiably ill, w ho face a futuIe of pain and

despair, and w ho w

ish to die w ill not have suffered a

loss ff they are killed. It is, sm ctly speaking, the value

of a hum an's futuie w

hich m akes kilhng w

aong in this theory This being so, kllhng does not necessarily w

rong som

e persons w ho are sick and dying. O

f com se, there

m ay be othei reasons for a plohibm

on of active euthana- sia, but that is another m

attei S anctity-of-hum

an-hfe theories seem

to hold that active euthanasia is seriously w

iong even m an individual case w

hele there seem s to

be good leason fol it independently of public policy

consldeiatÿons. T ins consequence ÿs m

ost im plausible,

and It is a plus fol the claim that the loss of a future of

value is w hat m

akes killing w iong that it does not shale

this consequence

In the fouith place, the account of the w rongness

o f killin

g d

e fe

n d

e d

in th

is e ssa

y d o

e s stra

ig h

tfo r-

w ardly entad that it is prim

a facie seliously w rong to

kill chddlen and infants, for w e do presum

e that they h a ve

fu tu

le s o

f va lu

e S

in ce

w e d

o b

e lie

ve th

a t it is

w rong to kill defenseless little babies, it is Im

portant that a theory of the w

rongness of killing easily account fo

r th is. P

e rso

n h o o d th

e o lle

s o f th

e w

ro n g n e ss o

f killin

g , o

n th

e o

th e

l h a

n d

, ca n

n o

t stia lg

h tfo

rw a

id ly

account for the w longness ofkllhng Infants and young

ch ild

re n H

e n ce

, su ch

th e o rie

s m u st a

d d sp

e cia

l a d

hoc accounts of the w longness of killing the young

The plauslbdaty of such ad hoc theories seem s to be

a function of how desperately one w

ants such theolleS to

w o rk. T

h e cla

im th

a t th

e p

iim a iy w

lo n g -m

a kin

g fe

a tu

ie o

f a killin

g is th

e lo

ss to th

e victim

o f th

e value of its futuie accounts for the w

iongness of kdhng yo

u n

g ch

ild re

n a

n d

In fa

n ts d

n e

ctly; it m a

ke s th

e w

ro n

g n

e ss o

f su ch

a cts a

s o b

w o

u s a

s w e

a ctu

a lly

th in

k It is T h is is a

fm th

e l m

e rit o

f th is th

e o ry

A ccordingly, it seem

s that this value of a future-hke- o

u rs

th e

m y o

f th e

w lo

n g

n e

s s o

f k illin

g s

h a

re s

stre n

g th

s o f b

o th

sa n

ctlty-o f-h

fe a

n d

p e

lso n

h o

o d

accounts w hile avoiding w

eaknesses of both. In addi- tio

n , It m

e sh

e s w

ith a

ce n tla

l in tu

itio n co

n cm

n ln

g w

hat m akes kllhng w

rong T

he claim that the pnm

aiy w rong-m

aking featm e

of a killing is the loss to the victim of the value of ItS

fu tu

ie h

a s o

b vio

u s co

n se

q u

e n

ce s fo

r th e

e th

ics o f

abom on. T

he futuie of a standald fetus includes a set o

f e xp

e rie

n ce

s, p ro

je cts, a

ctivitie s, a

n d

su ch

w h

ich are Identical w

ith the futures of adult hum an beings

and aie Identical w ith the futures of young children.

S ince the leason that is sufficient to explain w

hy it is w

long to k311 hum an beings aftel the tim

e of birth is a Ie

a so

n th

a t a

lso a

p p lie

s to fe

tu se

s, it fo llo

w s th

a t

abom on is piIm

a facle seriously m olally w

rong. T

his argum ent does not xely on the m

vahd lnfei- ence that, since it is w

rong to k311 persons, it is w rong

to kill p

o te

n tia

l p e lso

n s a

lso . T

h e ca

te g o ly th

a t IS

m o la

lly ce n tla

l to th

is a n a lysis is th

e ca

te g o ly o

f h

a vin

g a

va lu

a b

le fu

tu re

like o

re s, it is n

o t th

e ca

te -

gory of personhood. T he algum

ent to the conclusm n

that abortion is prim a facle seriously m

orally w xong

proceeded independently of the notion of person or

w ish to strut w

ith this analysis in term s of t

of a hum an futm

e, conclude that aboihon Is, except :ÿ p

e rh

a p

s in lin

e cilcu

m sta

n ce

s, se rio

u sly m

o la

lly w

lo n

g , ln

fe l th

a t fe

tu se

s h a

ve th

e H

g h

t to h

fe , a

n d

then call fetuses "persons" as a result of theu having th

e lig

h t to

h fe

. C le

a rly, in

th is ca

se , th

e ca

te g o ry o

f ;ÿ p

e lso

n is b

e in

g u

se d

to sta

te th

e co

n clu

sto n

o f th

e analysis lathei than to generate the argum

ent of the ÿi; a n a ly

s is

ÿ ::

T he structm

e of this antl-aborhon argum ent can be

both dlum inated and defended by com

paling it to w

hat appears to be the best argum ent for the w

long. ness of the w

anton infliction of pare on anim als. T

his latter argum

ent is based on the assum ption that it is

p ia

m a

fa cie

w lo

n g

to in

flict p a

in o

n m

e (o

r yo u

, leadel) W

hat is the natuial plopelty associated w ith

th e

In flictio

n o

f p a

in w

h ich

m a

ke s su

ch In

flictio n

w long? T

he obvious answ er seem

s to be that the Inflic- tio

n o

f p a

in ca

u se

s su ffe

rin g

a n

d th

a t su

ffe lm

g is a

m lsfo

ltu n

e T

h e

su ffe

rin g

ca u

se d

b y th

e In

flictio n

o f

p a

in is w

h a

t m a

ke s th

e w

a n

to n

In flictio

n o

f p a

in o

n m

e w

ro n g

T h e

w a

n to

n m

flm h o n o

f p a in

o n o

th e r

adult hum ans causes suffering T

he w anton Infliction

o f p

a in

o n

a n

im a

ls ca u

se s su

ffe lm

g S

in ce

ca u

sin g

suffering is w hat m

akes the w anton infliction of pain

w rong and since the w

anton infliction of pain on ani- m

als causes suffering, it follow s that the w

anton inflic- hon of pain on anim

als is w rong.

T h

is a rg

u m

e n

t fo r th

e w

lo n

g n

e ss o

f th e

w a

n to

n infliction of pain on anim

als shares a num ber of struc-

tural featm es w

ith the algum ent for the serious prim

a fa

ca e

w ro

n g

n e

ss o f a

b o

rtio n

B o

th a

Ig u

m e

n ts sta

lt w

ÿth a

n o

b vio

u s a

ssu m

p tio

n co

n ce

rn in

g w

h a t it is

w rong to do to m

e (ol you, leader) B oth then look

fol the chaxacteristic or the consequence of the w rong

action w hich m

akes the action w long. B

oth recognize th

a t th

e w

ro n

g -m

a kin

g fe

a tu

re o

f th e

se Im

m o

ra l

actions is a property of actions som etim

es diIected at individuals othei than postnatal hum

an beings If the stru

ctm e

o f th

e a

rg u

m e

n t fo

l th e

w ro

n g

n e

ss o f th

e w

a n

to n

in flictio

n o

f p a

in o

n a

n im

a ls is so

u n

d , th

e n

the shucture of the algum ent for the prim

a facie seli- ous w

rongness of abortion is also sound, for the stiuc- tree of the tw

o argum ents is the sam

e. T he structm

e com

m on to both is the key to the explanation of how

the w iongness of aboItion can be dem

onstiated w ith-

o u

t le e

o u

lse to

th e

ca te

g o

ly o f p

e lso

n In

n e

ith e

r algum

ent is that categoly crucial T

his defense of an argum ent fol the w

Iongness of abortion m

term s of a structurally slm

dar aigum ent for

',3t ÿ311.111 ÿJll tl.lll-

succeeds only if the account legarding anim als is

the conect account Is it9 In the filst place, st seem s

plausible. In the second place, its m ajol com

petition is K

ant's account. K ant beheved that w

e do not have d ile

ct d u tie

s to a

n im

a ls a

t a ll, b

e ca

u se

th e y a

re n

o t

p e lso

n s H

e n ce

, K a n t h

a d to

e xp

la in

a n d ju

stify th e

w rongness of inflicting pain on am

m als on the grounds

th a

t "h e

w h

o is h

a id

m h

is d e

a lin

g s w

ith a

n im

a ls

b e co

m e s h

a rd

a lso

in h

is d e a lin

g w

ith m

e n ''ÿ T

h e

ploblem w

ith K ant's account is that there seem

s to be no leason for accepting this latteÿ claim

unless K ant's

account is rejected. If the alteinahve to K ant's account

is accepted, then it is easy to undelstand w hy som

e- one w

ho is indifferent to lnfhctm g pain on anim

als is a lso

in d lffe

le n t to

in flictin

g p

a in

o n h

u m

a n s, fo

l o n e

is in d

iffe re

n t to

w h

a t m

a ke

s in flictin

g p

a in

w ro

n g

m both cases B

ut, if K ant's account is accepted, there is

no intelligible leason w hy one w

ho IS hald in his deal-

ings w ith anim

als (ol crabglass or stones) should also b e h

a rd

in h

is d e a lin

g s w

ith m

e n . A

fte r a

ll, m e n a

re pelsons: anim

als ale no m ore peisons than crabgrass

or stones P ersons are K

ant's crucial m olal category

W hy, m

sholt, should a K antian accept the basic claim

in K ant's algum

ent9 H

e n

ce , K

a n

t's a rg

u m

e n

t fo r th

e w

ro n

g n

e ss o

f in

flictin g

p a

in o

n a

n im

a ls le

sts o n

a cla

im th

a t, m

a w

orld of K antian m

olal agents, is dem onstlably false.

T herefoIe, the alternative analysis, being m

ore plau- sible anyw

ay, should be accepted. S ince this alterna-

tive analysis has the sam e structure of the antl-aboltlon

argum ent being defended hele, w

e have further sup- polt for the argum

ent for the lm m

oxahty of aboltaon being defended in this essay.

O f co

u lse

, th is va

lu e o

f a fu

tm e -h

ke -o

u rs a

rg u -

m ent, if sound, show

s only that abortion is prim a facle

w xo

n g , n

o t th

a t it is w

ro n g

in a

n y a

n d a

ll circu m

- sta

n ce

s. S in

ce th

e lo

ss o f th

e fu

tm e

to a

sta n

d m

d fetus, if killed, is, how

ever, at least as gieat a loss as the loss of the futm

e to a standard adult hum an being

w h o is kille

d , a

b o rtio

n , like

o Id

m a ly killin

g , co

u ld

b e

justified only by the m ost com

pelling leasons. T he

loss of one's hfe IS alm

ost the gleatest m lsfoItune that

can happen to one. P lesum

ably abom on could be jus-

tified m som

e cucum stances, only ff the loss conse-

q u e n t o

n fa

lh n g to

a b o rt w

o u ld

b e a

t le a st a

s g le

a t.

A ccordingly, m

orally perm issible abom

ons w ill be

ra le

in d

e e

d u

n le

ss, p e

rh a

p s, th

e y o

ccu r so

e a

rly m pxegnancy that a fetus is not yet definitely an individ- ual. H

ence, this algum ent should be taken as show

ing th

a t a

b o

rtio n

is p le

su m

p tlve

ly ve ry se

rio u

sly w lo

n g

,

w h

e le

th e

p le

su m

p tm

n is ve

ly stro n

g --a

s stlo n

g a

s the presum

ption that killing anothel adult hum an being

xs w ro

n g

.

III H

ow com

plete an account of the w rongness of killing

does the value of a futm e-hke-ours account have to be

m o

ld e

r th a

t th e

w ro

n g

n e

ss o f a

b o

rtio n

is a co

n se

- quence9 T

his account does not have to be an account o f th

e n

e ce

ssa ry co

n d itio

n s fo

r th e w

ro n g n e ss o

f killin

g S

o m

e p

e rso

n s in

n u

isln g

h o

m e

s m a

y la ck

va lu

a b le

h u m

a n fu

tu re

s, ye t it m

a y b

e w

ro n g to

kill them

fol other leasons. F m

theim oxe, this account does

n o

t o b

vio u

sly h a

ve to

b e

th e

so le

re a

so n

kllh n

g xs

w ro

n g w

h e ie

th e victim

d id

h a ve

a va

lu a b le

fu tu

re T

h is a

n a lysis cla

im s o

n ly th

a t, fo

r a n y killin

g w

h e re

the victim did have a valuable future like ouis, having

that future by itself is sufficient to cleate the stlong presum

ption that the killing is sellously w rong

O ne w

ay to overturn the value of a future-like-ouis argum

ent w ould be to find som

e account of the w a ong-

ness of killing w hich is at least as m

telhglble and w

h ich

h a s d

iffe re

n t lm

p h ca

tlo n s fo

r th e e

th ics o

f abortion. T

w o rival accounts possess at least som

e d

e g

a e

e o

f p la

u sib

ility O n

e a

cco u

n t is b

a se

d o

n th

e obw

ous fact that people value the experience of living a n d w

ÿsh fo

r th a t va

lu a b le

e xp

e lle

n ce

to co

n tin

u e

T herefore, it m

ight be said, w hat m

akes killing w long

is the discontinuation of that experience for the victim .

Let us call this the dtscontm uation account A

nother rival account is based upon the obvious fact that people strongly desire to continue to live T

his suggests that w

h a t m

a ke

s kllh n g u

s so w

lo n g IS

th a t it m

te ffe

le s

w ith the fulfillm

ent of a strong and fundam ental desire,

the fulfillm ent of w

hich is necessaly fol the fulfill- m

ent of any othex desiles w e m

ight have. Let us call this the destle account.2

C onsider filst the desue account as a rival account

of the ethics of kalhng w hich w

ould provide the basis fol lejectlng the antI-abom

on position S uch an account

w ill h

a ve

to b

e stro

n g

e l th

a n

th e

va lu

e o

f a fu

tm e

- hke-om

s account of the w rongness of abortion if it is

to do the job expected of it T o entail the w

longness o f a

b O

ltlo n , th

e va

lu e o

f a fu

tu a e -h

ke -o

m s a

cco u n t

has only to paovlde a sufficient, but not a necessary, co

n d

itio n

fo l th

e w

ro n

g n

e ss o

f kllh n

g . T

h e

d e

sire account, on the othel hand, m

ust plovlde us also w ith

a necessary condition for the w longness of killing m

older to genelate a pro-choice conclusion on aboltion

T he Ieason fol this is that pIesum

ably the argum ent

fio m

th e

d e

sire a

cco u

n t m

o ve

s fro m

th e

cla im

th a

t w

h a t m

a ke

s kilh n g w

Io n g is ln

te lfe

le n ce

w ith

a ve

ry stlo

n g

d e

slle to

th e

cla im

th a

t a b

o rtio

n is n

o t w

ro n

g b e ca

u se

th e fe

tu s la

cks a stio

n g d

e sxle

to live

O b -

vio u sly, th

is re fe

re n ce

fa ils if so

m e o n e 's h

a vin

g th

e desire to live is not a necessary condition of its being w

rong to kill that individual. O

ne problem w

ith the desile account is that w e do

regard it as S ellously w

rong to kill pelsons w ho have

h ttle

d e sile

to live

o l w

h o h

a ve

n o d

e siie

to live

o r,

indeed, have a desire not to live W e believe it is seri-

o u sly w

to n g to

kill th e u

n co

n scio

u s, th

e sle

e p in

g ,

th o se

w h o a

le tile

d o

f h fe

, a n d th

o se

w h o a

re su

ici- d

a l T

h e

va lu

e -o

f-a -h

u m

a n

-fu tu

re a

cco u

n t le

n d

e rs

sta n

d a

rd m

o ra

lity In te

llig ib

le in

th e

se ca

se s; th

e se

ca se

s a p

p e

a r to

b e

in co

m p

a tlb

le w

ith th

e d

e su

e account

The desire account is subject to a deepel difficulty W

e desire fife, because w e value the goods of this hfe

T he goodness of life is not secondaly to our desire for

It. If th is w

e re

n o

t so , th

e p

a in

o f o

n e

's o w

n p

re m

a -

rule death could be done aw ay w

ith m erely by an

a p p ro

p ria

te a

lte la

tlo n in

th e co

n fig

u ra

tio n o

f o n e 's

desires. T his is absuld. H

ence, it w ould seem

that it is th

e lo

ss o f th

e g

o o d s o

f o n e 's fu

tu le

, n o t th

e in

- terference w

ith the fulfiilm ent of a strong desire to

live , w

h ich

a cco

u n ts u

ltim a te

ly fo I th

e w

lo n g n e ss o

f killing

It is w olth noting that, if the desire account is m

od- Ified so that it does not provide a necessaly, but only a su

fficie n t, co

n d itio

n fo

l th e w

ro n g n e ss o

f killin g ,

the desn'e account is com patible w

ith the value of a futule-hke-ouis account T

he com bined accounts w

ill yie

ld a

n a

n ti-a

b o

itio n

e th

ic T h

is su g

g e

sts th a

t o n

e can ietain w

hat is Intuitively plausible about the desire account w

ithout a challenge to the basic argum ent of

this papel It is a

lso w

o rth

n o tin

g th

a t, if fu

tu re

d e sire

s h a ve

m olal force in a m

odified desne account of the w rong-

ness of kilhng, one can find suppolt fol an anti-abolÿlO n

ethic even in the absence of a value of a futuIe-hke- O

U lS

account If one decides that a m olally relevant

property, the possession of w hich is sufficient to m

ake it w

long to kill som e Individual, is the desue at som

e futm

e tim e to lave--one m

ight decide to justify one's Iefusal to kill suicidal teenagels on these grounds, fol e

xa m

p le

--th e

n , sin

ce typ

ica l fe

tu se

s w ill h

a ve

th e

destre m the future to hve, it is w

long to kill typical

te tu

se s. A

cco rd

in g ly, it d

o e s n

o t se

e m

th a t a

account of the w Iongness of kflhng can provide ajus,

h fica

h o n o

f a p

io -ch

o lce

e th

ic o f a

b o Ih

o n w

h ich

is nearly as adequate as the value of a hum

an-future jus- hfication of an anh-abortlon ethic.

T he discontinuation account looks m

ole plom ising

a s a

n a

cco u n t o

f th e w

io n g n e ss o

f killin g . It se

e m

s ju

st a s In

te llig

ib le

a s th

e va

lu e o

f a fu

tu re

-like -o

u rs

account, but it does not justify an anti-abortion posi- tion O

bviously, if it is the continuation of one's activ- itie

s, e xp

e rie

n ce

s, a n

d p

ro je

cts, th e

lo ss o

f w h

ich m

akes kllhng w long, then it is not w

rong to kill fetuses for that reason, for fetuses do not have expeuences, activities, and plojects to be continued o1" dlsconfin. u e d A

cco ld

in g ly, th

e d

isco n tin

u a tio

n a

cco u n t d

o e s

not have the antl-aboltion consequences that the value of a future-hke-ours account has. Y

et at seem s as lntel-

hglble as the value of a future-hke-ouls account, fur w

hen w e think of w

hat w ould be w

Iong w ith our

being killed, at does seem as if it is the discontinua_

tlon of w hat m

akes our hves W O

lthw hile w

hich m akes

killing us w rong.

Is th e d

isco n tin

u a tio

n a

cco u n t ju

st a s g

o o d a

n a

cco u

n t a

s th e

va lu

e o

f a fu

tm e

-like -o

u rs a

cco u

n t?

T he discontinuation account w

ill not be adequate at all, if it does not refer to the value of the experience that m

ay be discontinued. O ne does not w

ant the dis- continuation account to m

ake it w rong to kill a patient

w ho begs for death and w

ho is in severe pain that cannot be leheved short of killing (I leave open the q u e stio

n o

f w h e th

e r it IS

w lo

n g fo

r o th

e r re

a so

n s.)

A cco

rd in

g ly, th

e d

isco n tin

u a tio

n a

cco u n t m

u st b

e m

o re

th a

n a

b a

re d

isco n

tin u

a tio

n a

cco u

n t It m

u st

m a ke

so m

e le

fe xe

n ce

to th

e p

o sitive

va lu

e o

f th e

p a

tie n

t's e xp

e rie

n ce

s. B u

t, b y th

e sa

m e

to ke

n , th

e value of a futule-hke-ours account cannot be a bare future account either Just having a future surely does not itself rule out kllhng the above patient. T

his account m

ust m ake som

e refeience to the value of the patient's future experiences and projects also. H

ence, both accounts involve the value of expellences, pro- je

cts, a n d a

ctivitie s. S

o fa

l w e still h

a ve

sym m

e try

betw een the accounts.

T he sym

m etry fades, how

evei, w hen w

e focus on the tim

e pelIod of the value of the experiences, etc., w

hich has m olal consequences. A

lthough both accounts leave open the possibility that the patient in our exam

- ple m

ay be killed, this possibility is left open only in vntue of the utterly bleak futule for the patient. It m

akes no difference w hether the patient's Im

m ediate

past contains intolerable pain, or consists m being m

(w hich w

e can Im agine is a situation of indif-

ol consists in a hfe of value. If the patient's is a

fu tu

re o

f va lu

e , w

e w

a n t o

u r a

cco u n t to

m ake it w

long to kill the patient. If the patient's futule is intoleaable, w

hatever his ol hei im m

ediate past, w e

w a

n t o

u r a

cco u

n t to

a llo

w killin

g th

e p

a tie

n t. O

b -

vio u

sly, th e

n , it is th

e va

lu e

o f th

a t p

a tie

n t's fu

tu le

w hich is doing the w

ork in rendeling the m olallty of

killing the patient lntelhgible T

his being the case, it seem s cleal that w

hethel one has im

m ediate past experiences or not does not w

oik in the explanation of w

hat m akes killing w

long The addition the discontinuation account m

akes to the value of a hum

an future account is otiose. Its addition to the value-of-a-future account plays no lole at all in ren- dering intelligible the w

rongness of killing Therefoie, It can be discarded w

ith the discontinuation account of w

hich it is a part.

IV T

h e a

n a lysis o

f th e p

re vio

u s se

ctio n su

g g e sts th

a t

a lte

ln a

tlve g

e n

e ia

l a cco

u n

ts o f th

e w

io n

g n

e ss o

f killing aie either inadequate ol unsuccessful in getting m

ound the anti-abortion consequences of the value of a fu

tu le

-like -o

u is a

rg u m

e n t A

d iffe

re n t stla

te g y fo

l avoiding these antl-aboltlon consequences involves lirm

tm g the scope of the value of a futule argum

ent. M

ole plecisely, the strategy involves arguing that fetuses lack a plopelty that as essential for the value- o f-a

-fu tu

le a

rg u m

e n t (o

r fo r a

n y a

n ti-a

b o ltlo

n a

lg u -

m ent) to apply to them

. O

ne m ove of this suit is based upon the claim

that a necessary condition of one's futule being valuable is th

a t o

n e

va lu

e s it. V

a lu

e im

p lie

s a va

lu e

r G ive

n this, one m

ight aigue that, since fetuses cannot value th

e ir fu

tu re

s, th e ir fu

tu re

s a re

n o t va

lu a b le

to th

e m

H ence, It does not seriously w

long them dehbelately

to end theu lives T

his m ove fails, how

evel, because of som e am

bi- g u itie

s L e t u

s a ssu

m e th

a t so

m e th

in g ca

n n o t b

e o

f value unless it is valued by som

eone. T his does not

entail that m y hfe is of no value unless it is valued by

m e. I m

ay think, in a period of despaiI, that m y future

is of no W olth w

hatsoevel, but I m ay be w

long because o th

e rs ilg

h tly se

e va

lu e --e

ve n g

le a t va

lu e --in

a t

F urtherm

ore, m y futuie can be valuable to m

e even if I do not value it T

his is the case w hen a young person

attem pts suicide, but as rescued and goes on to signif-

ica n t h

u m

a n a

ch ie

ve m

e n ts S

u ch

yo u n g p

e o p le

's futures are ultm

lately valuable to them , even though

q n e h f'n

tu ro

q d

n n

n t q

o a rn

tn h

a v

n ln

n h lo

tn th

o rn

n t th

e ,

D O

N M

A R

Q U

IS 3 51

m om

ent of attem pted suicide. A

fetus's futuie can be va

lu a

b le

to it m

th e

sa m

e w

a y A

cco ld

m g

ly, th is

attem pt to lim

it the antl-aboltlon algum ent falls.

A nothel slm

ilal attem pt to reject the antl-aboltlon

p o sitio

n is b

a se

d o

n T

o o le

y's cla im

th a t a

n e

n tity

cannot possess the H ght to life unless it has the capac-

ity to d

e sire

its co n

tin u

e d

e xiste

n ce

It fo llo

w s th

a t,

since fetuses lack the conceptual capacity to desne to continue to live, they lack the right to life. A

ccoldingly, T

o o le

y co n clu

d e s th

a t a

b o rtio

n ca

n n o t b

e se

rio u sly

p rim

a fa

cie w

io n g (u

p . clt, p

p 4

6 /7

).. O

ne m ight attem

pt to defend T ooley's basic claim

on the grounds that, because a fetus cannot applehend continued hfe as a benefit, its continued life cannot be a benefit or cannot be som

ething it has a right to or cannot be som

ething that is m its lnteiest. T

his m ight

be defended in term s of the general plopositlon that,

if an individual is literally incapable of caring about o

r ta kin

g a

n in

te le

st in so

m e

X , th

e n

o n

e d

o e

s n o

t have a right to X

or X is not a benefit ol X

is not som e-

thing that is in one's interest.3 E

ach m em

bea of this fam ily of claim

s seem s to be

open to objections . . A s T

ooley him self has pointed

out, pelsons w ho have been indoctrinated, or drugged,

01 lendeled tem polarlly unconscious m

ay be htelally in

ca p

a b

le o

f C a

lln g

a b

o u

t o l ta

kin g

a n

ln te

le st in

som ething that is in then interest or is som

ething to w

hich they have a right, or as som ething that benefits

them . H

ence, the T ooley claim

that w ould lestrict the

sco p e o

f th e va

lu e o

f a fu

tu re

-like -o

u rs a

ig u m

e n t is

underm ined by counterexam

ples.4 F

inally, P aul B

assen5 has argued that, even though the plospects of an em

bryo m ight seem

to be a basis for the w

rongness of aboltlO n, an em

blyo cannot be a victim

and therefole cannot be w ronged A

n em bryo

cannot be a victim , he says, because it lacks sentlence.

H is centaal m

gum ent for this seem

s to be that, even though plants and the perm

anently unconscious axe alive, they cleaily cannot be victim

s W hat is the

explanation of this9 B assen claim

s that the explana- tion is that their lives consist of m

ele m etabohsm

and m

ere m etabolism

as not enough to glound vlctlm lz-

ability M entation as lequared.

T he problem

w ith this attem

pt to estabhsh the absence of V

lctim lzability is that both plants and

th e

p e

rm a

n e

n tly u

n co

n scio

u s cle

a lly la

ck w h

a t

B a

sse n

ca lls "p

lo sp

e cts" o

r w h

a t I h

a ve

ca lle

d "a

fu tu

re life

like o

u rs." H

e n

ce , it is su

re ly o

p e

n to

n n o tn

n ra

n o th

n t th

o rÿ

n [ lo

n q o n w

e ÿ h

o , liÿ

v e n

la n ts

352 R EPR

O D

U C

TIO N

and the perm anently unconscious cannot be victim

s is th

a t killin

g th

e m

ca n

n o

t d e

p rive

th e

m o

f a fu

tu le

life like

o u rs; th

e le

a l re

a so

n is n

o t th

e ir a

b se

n ce

o f

p re

s e n t m

e n ta

tm n ...

one9 T his altelnative does not yield an actual subject

o f h

a im

ra th

e r A

cco ld

m g ly, th

e im

m o ia

h ty o

f co n -

tra ce

p tio

n IS

n o t e

n ta

ile d b

y th e lo

ss o f a

fu tm

e _

hke-ouis argum ent sim

ply because theie is no nonar- bItlarily Identifiable subject of the loss in the case of contraception

353

V In this essay, It has been aigued that the conect ethic of the w

rongness of killing can be extended to fetal life and used to show

that them is a strong piesum

p- tion that any aboltion is m

olally Im perm

issible. If the e

th ic o

f killin g

a d

o p

te d

h e

re e

n ta

ils, h o

w e

ve l, th

a t

co n tla

ce p tlo

n is a

lso se

ilo u sly im

m o ra

l, th e n th

e re

w ould appeal to be a difficulty w

ith the analysis of this essay.

B ut this analysis does not entail that contraception

is w iong O

f C O

U lS

e, contiaception pievents the actu- a

liza tio

n o

f a p

o ssib

le fu

tu re

o f va

lu e

. H e

n ce

, it fo l-

low s from

the claim that futm

es of value should be m

axim ized that contraception is prim

a facie im m

oral. T

his obligation to m axim

ize does not exist, how evei,

fu rth

e lm

o ie

, n o

th in

g in

th e

e th

ics o f kllh

n g

in th

is paper entails that it does. The ethics of kllhng in this essay w

ould entail that contlaceptlon is w iong only if

so m

e th

in g w

e re

d e n ie

d a

h u m

a n fu

tu re

o f va

lu e b

y co

n tia

ce p

tio n

N o

th in

g a

t a ll is d

e n

ie d

su ch

a fu

tu re

by contraception, how evel.

C andidates for a subject of haim

by contlaceptlon fall into foul categones (1) som

e sperm oi other, (2)

som e ovum

ol other, (3) a sperm and an ovum

sepa- lately, and (4) a sperm

and an ovum together. Assigning

th e h

a lm

to so

m e sp

e rm

is u tte

rly a rb

itra ry, fo

r n o

leason can be given foi m aking a speim

the subject of haim

iathm than an ovum

A ssigning the harm

to som e

o vu

m is u

tte lly m

b itra

ry, fo r n

o ie

a so

n ca

n b

e g

ive n

for m aking an ovum

the subject of haim lather than a

sperm . O

ne m ight attem

pt to avoid these problem s by

insisting that contraception depnves both the spelm and the ovum

sepaIately of a valuable futule like O U

lS .

O n

th is a

lte rn

a tive

, to o

m a

n y fu

tu re

s a re

lo st. C

o n

- tlaception w

as supposed to be w rong, because it de-

p rive

d u

s o f o

n e fu

tu re

o f va

lu e , n

o t tw

o O

n e m

ig h t

attem pt to avoid this ploblem

by holding that contra- ception deprives the com

bination of spelm and ovum

o f a

va lu

a b le

fu tu

re like

O U

lS . B

u t h

e le

th e d

e fin

ite aiticle m

isleads. A t the tim

e of contlaceptlon, thele ale h u n d le

d s o

f m illio

n s o

f sp e im

, o n e 0

e le

a se

d ) o

vu m

and m illions of possible com

binations of all of these. T

hem IS

no actual com bm

atlon at all. Is the subject of fh

+ la

+ ÿ fn

h ,ÿ

ÿ m

,ÿ ,M

x , n

n t, e

ll'ÿ |tÿ

o n

m ÿ ln

ÿ fln

n 9

X X

lh +

o h

v I

T he purpose of this essay has been to set out an ar-

g u m

e n t fo

I th e se

llo u s p

re su

m p tive

w lo

n g n e ss o

f abortion subject to the assum

ption that the m oral per-

m lssib

lllty o f a

b o

rtio n sta

n d

s o I fa

lls o n

th e

m o

la l

status of the fetus. S ince a fetus possesses a propm

ty, the possession of w

hich in adult hum an beings is suf-

ficient to m ake killing an adult hum

an being w iong,

abortion is w rong T

his w ay of dealing w

ith the prob- lem

of aboition seem s supenor to othel approaches to

the ethics of abortion, because it lests on an ethics of killin

g w

h ich

is clo se

to se

lf-e vid

e n

t, b e

ca u

se th

e cru

cia l m

o la

lly le le

va n

t p ro

p e

rty cle a

rly a p

p lie

s to fetuses, and because the aigum

ent avoids the usual e q u ivo

ca tio

n s o

n "h

u m

a n life

," "h u m

a n b

e in

g ," o

i "p

e rso

n ." T

h e a

ig u m

e n t re

sts n e ith

e r o

n le

llg lO

U s

cla im

s n o

r o n

P a

p a

l d o

g m

a It is n

o t su

b je

ct to th

e objection of "specleslsm

" Its soundness is com pati-

ble w ith the m

oral perm issibility of euthanasia and

contiaception. It deals w ith our Intuitions conceining

young childlen F

inally, this analysis can be view ed as resolving a

sta n

d a

id p

ro b

le m

--in d

e e

d , th

e sta

n d

a id

p ro

b le

m --

concerning the ethics of aboltion. C learly, it is w

long to kill adult hum

an beings. C learly, it is not w

rong to end the life of som

e albltrm ily chosen single hum

an cell F

etuses seem to be hke arbltrm

fly chosen hum an

cells in som e respects and like adult hum

ans in other respects. T

he pIoblem of the ethics of abortion is the

ploblem of detm

m inm

g the fetal pm peIty that settles

this m oral controversy T

he thesis of this essay is that the pIoblem

of the ethics of aboition, so undelstood, is solvable.

N O

TES 1

"D u

tie s to

A m

m a

ls a

n d

S p

irits ," m

L e

c tu

re s o

n E

th ic

s ,

Louis Infeld, tlans (N ew

Y olk H

m peI, 1963), p 239

2 P resum

ably a piefeienee utlhtauan w ould press such an

objection Tooley once suggested that his account has such a theo- letical underpxnm

ng S ee his "A

bortion and Infanticide," P hilosophy

and Pubhc Affairs 2 (1972), pp 44-5 3 D

onald V anD

eV eei seem

s to think this self-evident S ee his

"W hlthei B

aby D oe9'' m

M atters of Life and D

eath, p 233 4 S

ee T ooley again in "A

bom on and Infanticide," pp 47-49

5 "P resent S

akes and F utuie P

rospects T he S

tatus of E aily

J U

D IT

H J

A R

V IS

T H

O M

S O

N

A D

efense of A bortion

Judith Jarvls T hom

son, P rofessor of P

hilosophy at the M assachusetts Institute

of T echnology, w

orks in both ethics and m etaphysics H

er book R ealm

of R ,ghts

(H arvard) is a com

prehensive theory of the subject R epresentative publications

include "S elf-D

efense," P hdosophy and P

ublzc A ffaÿ)s, "O

n S om

e W ays in w

hich a T

hing C an B

e G ood," S

ocm l P

lulosophy and P ohcy, aim

"P hysician-A

ssisted S uicide:

T w

o M oral A

igum ents," E

thics

M ost opposition to abom

on iehes on the pm lm

se that the fetus IS

a hum an being, a person, fiom

the m om

ent o

f co n

ce p

tio n

. T h

e p

re m

ise is a

ig u

e d

fo l, b

u t, a

s I think, not w

ell T ake, for exam

ple, the m ost com

m on

argum ent W

e am asked to notice that the develop-

m ent of a hum

an being flora conception through birth in

to ch

ild h o o d is co

n tin

u o u s; th

e n it is sa

id th

a t to

dlaW a line, to choose a point in this developm

ent and say "before this point the thing is not a pm

son, aftra this point it is a person" is to m

ake an aibitrm y choice,

a ch

o ice

fo i w

h ich

in th

e n

a tu

le o

f th in

g s n

o g

o o

d m

ason can be given. It is concluded that the fetus is, O

l anyw ay that w

e had bettei say it is, a person from the m

om ent of conception B

ut this conclusion does not follow

. S im

ilar things m ight be said about the

developm ent of an acorn into an oak tiee, and it does

n o t fo

llo w

th a t a

co rn

s m e o

a k rice

s, o i th

a t w

e h

a d

better say they am A

lgum ents of this form

ale som e-

tim es called "slippery slope aigum

ents"--the phiase is pm

haps self-explanatoiy--and it is dism aying that

o p p o n e n ts o

f a b o rtio

n re

ly o n th

e m

so h

e a vily a

n d

uncritically. I am

inclined to agree, how ever, that the prospects

fo l "d

ra w

in g

a lin

e " in

th e

d e

ve lo

p m

e n

t o f th

e fe

tu s

look dim . I am

inclined to think also that w e shall

plobably have to agxee that the fetus has already b

e co

m e

a h

u m

a n

p e

lso n

w e

ll b e

fo ie

b ilth

In d

e e

d , it

com es as a surprise w

hen one filS t learns how

early in its hfe it begins to acquaie hum

an chalactelistlcs. B y

F rom

P hilosophy and P

ubhc A ffairs 1, no 1 (1971), 47-66

C opyilght ©

1971 by Blackw ell Pubhshm

g R epim

ted w ith per-

th e

te n

th w

e e

k, fo l e

xa m

p le

, it a lre

a d

y h a

s a fa

ce ,

arm s and legs, fingers and toes, at has lntelnal olgans,

and biam activity is detectable 2 O

n the othel hand, I think that the piem

lse is false, that the fetus IS not a

pelson flom the m

om ent of conception. A

new ly fei-

tfllzed ovum , a new

ly im planted clum

p of cells, is no m

oie a pelson than an acorn is an oak tree. B ut I shall

n o

t d iscu

ss a n

y o f th

is F o

r it se e

m s to

m e

to b

e o

f gieat lntm

est to ask w hat happens If, fo1 the sake of

algum ent, w

e allow the prem

ise. H ow

, precisely, aie w

e supposed to get from there to the conclusion that

aboltion is m olally im

perm issible9 O

pponents of a b o itio

n co

m m

o n ly sp

e n d m

o st o

f th e n tim

e e

sta b -

lishing that the fetus is a pm son, and haidly any tim

e explaining the step from

there to the im perm

issibility o

f a b

o ltio

n . P

e rh

a p

s th e

y th in

k th e

ste p

to o

sim p

le a

n d

o b

vio u

s to ie

q u

a re

m u

ch co

m m

e n

t O l p

e rh

a p

s in

ste a

d th

e y a

le sim

p ly b

e in

g e

co n

o m

ica l in

a rg

u -

m ent M

any of those w ho defend abortion 1ely on the

prem ise that the fetus is not a pm

son, but only a bit of tissue that w

ill becom e a peison at bn'th; and w

hy pay out m

ole argum ents than you have to9 W

hatever the explanation, I suggest that the step they take is neither easy nol obvious, that it calls for closer exam

- m

arion than it is com m

only given, and that w hen w

e do give it this closeI exam

ination w e shall feel inclined

to ie

je ct It

I p ro

p o se

, th e n , th

a t w

e g

ra n t th

a t th

e fe

tu s is a

person flora the m om

ent of conception H ow

does the argum

ent go fiom hm

e9 S om

ething hke this, I take it. E

ve ly p

e lso

n h

a s a

lig h

t to life

. S o

th e

fe tu

s h a

s a nÿht to life. N

o doubt the m othel has a light to decide

w hat shall happen in and to he1 body; everyone w

ould gÿant that B

ut sulely a person's light to hfe is stronger and m

oie stringent than the m othel's H

ght to decide w

hat happens in and to hel body, and so outw eighs it

S o the fetus m

ay not be killed; an aboltion m ay not

be pelform ed.

It so u

n d

s p la

u sib

le . B

u t n

o w

le t m

e a

sk yo u

to Im

a g

in e

th is. Y

o u

w a

ke u

p in

th e

m o

rn in

g a

n d

fin d

yo u

lse lf b

a ck to

b a

ck in b

e d

w ith

a n

u n

co n

scio u

s vlo

lIm st A

fa m

o u

s u n

co n

scio u

s vio h

m st. H

e h

a s

b e

e n

fo u

n d

to h

a ve

a fa

ta l kid

n e

y a ilm

e n

t, a n

d th

e S

ociety of M usic Lovels has canvassed all the avail-

able m edical lecords and found that you alone have

the right blood type to help T hey have thesefore

ksd n

a p

p e

d yo

u , a

n d

la st n

ig h

t th e

vlo lln

lS t'S

cn cu

- la

to ry syste

m w

a s p

lu g g e d in

to yo

u rs, so

th a t yo

u r

kid n e ys ca

n b

e u

se d to

e xh

a ct p

o iso

n s fro

m h

is b lo

o d a

s w e ll a

s yo u i o

w n T

h e d

lle C

to l o

f th e h

o s-

p ita

l n o w

te lls yo

u , "L

o o k, w

e 're

so riy th

e S

o cie

ty o f M

u sic L

o ve

rs d id

th is to

yo u --w

e w

o u ld

n e ve

r h

a ve

p e

rm itte

d it if w

e h

a d

kn o

w n

. B u

t still, th e

y did it, and the vIohm

st now IS

plugged into you. To unplug you w

ould be to kill him B

ut never m ind,

it's o

n ly

fo r n

in e m

o n th

s . B

y th

e n h

e w

ill h a v e

re c o ve

le d flo

ra h

ss a

ilm e n t, a

n d c

a n sa

fe ly

b e

u n p lu

g g e d fio

m yo

u ." Is it m

o la

lly in cu

m b e n t o

n yo

u to

a cce

d e

to th

is situ a

tm n

9 N

o d

o u

b t it w

o u

ld be vesy nice of you if you did, a gleat kindness. B

ut do you have to accede to it9 W

hat If it w ere not nine

m onths, but nine yem

s? O I longer still9 W

hat if the d lre

cto l o

f th e h

o sp

ita l sa

ys, "T o u g h lu

ck, I a g re

e ,

b u t yo

u 've

n o w

g o t to

sta y in

b e d , w

ith th

e vio

lin -

ist plugged into you, for the rest of youl life. B ecause

le m

e m

b e

l th is A

ll p e

rso n

s h a

ve a

rig h

t to life

, a n

d vIo

lim sts a

re p

e lso

n s G

ia n

te d

yo u

h a

ve a

rig h

t to d e cid

e w

h a t h

a p p e n s in

a n d to

yo u r b

o d y, b

u t a

p e lso

n 's rig

h t to

life o

u tw

e ig

h s yo

u 1 rig

h t to

d e cid

e w

h a

t h a

p p

e n

s in a

n d

to yo

u i b

o d

y S o

yo u

ca n

n o

t e

ve i b

e u

n p

lu g

g e

d fro

m h

im ." I Im

a g

in e

yo u

w o

u ld

Iegm d this as ouhageous, w

hich suggests that som e-

thing really is w long w

ith that plausible-sounding algum

ent I m entioned a m

om ent ago.

In this case, of course, you w ere kidnapped; you

dsdn't volunteel foi the operation that plugged the w

o h n lst In

to yo

u r kid

n e ys. C

a n th

o se

w h o o

p p o se

abortion on the giound I m enhoned m

ake an excep- tion foi a psegnancy due to rape9 C

ertainly T hey can

say that persons have a light to life only ff they didn't com

e snto existence because of iape, or they can say

m a t a

sl p e lso

n s h

a ve

a rig

h t to

life , b

u t th

a t

h a ve

le ss o

f a H

g h t to

life th

a n o

th e rs, m

p a lticu

la i,

that those w ho cam

e into existence because of rape have less. B

ut these statem ents have a sathei" unpleas,

a n

t so u

n d

S u

re ly th

e q

u e

stm n

o f w

h e

th e

i yo u

h a

ve a lig

h t to

life a

t a ll, o

l h o w

m u ch

o f it yo

u h

a ve

, shouldn't turn on the queshon of w

hether or not you are the product of a 1 ape A

nd in fact the people w ho

o p p o se

a b o itlo

n o

n th

e g

ro u n d I m

e n tio

n e d d

o n

o t

m ake this distInctm

n, and hence do not m ake an excep_

tion In case of lape

N o1 do they m

ake an exception for a case m w

hsch the m

other has to spend the nine m onths of hes preg-

nancy m bed. They w

ould aglee that w ould be a great

pity, and haId on the m othei; but all the sam

e, all per- sons have a light to life, the fetus is a pelson, and so o n I su

sp e ct, m

fa ct, th

a t th

e y w

o u ld

n o t m

a ke

a n

exception for a case in w hich, m

iraculously enough, the plegnancy w

ent on for nine yem s, O

l even the rest of the m

other's life S

om e w

on't even m ake an exception foÿ a case in

w hich contlnuahon of the pregnancy is likely to

sh o rte

n th

e m

o th

e l's life

, th e y re

g a rd

a b o rtio

n a

s lm

p e

Im lssa

b le

e ve

n to

sa ve

th e

m o

th e

l's h fe

S u

ch cases ale now

adays very 1m e, and m

any opponents of aboition do not accept this extrem

e view . A

ll the sam e,

it is a g

o o d p

la ce

to b

e g in

a n

u m

b e r o

f p o in

ts o f

interest com e out in lespect to it

1 Let us call the view that abortion ss im

peim issi-

ble even to save the m other's life "the extlem

e view ."

I w ant to suggest tilst that st does not issue from

the algum

ent I m entioned earliel w

ithout the addition of som

e falH y pow

eIful piem Ises. S

uppose a w om

an has becom

e pregnant, and now learns that she has a cat-

diac condition such that she w ill die if she carries the

baby to term . W

hat m ay be done fol hel? The fetus,

being a person, has a right to life, but as the m other is

a p

e lso

n to

o , so

h a s sh

e a

lig h t to

h fe

. P re

su m

a b ly

they have an equal right to hfe. H ow

is it supposed to com

e out that an aboltlon m ay not be perfolm

ed? If m

other and child have an equal right to life, shouldn't w

e peihaps flip a corn? O 1 should w

e add to the m

othe?s light to life hel right to decide w hat happens

in and to her body, w hich everybody seem

s to be le

a d

y to g

ia n

t--th e

su m

o f h

e r lig

h ts n

o w

o u

tw e

ig h

- ing the fetus's light to life9

T he m

ost falm hal argum

ent here is the follow ing.

W e are told that perform

ing the abom on w

ould be dnectly kllhng3 the child, w

heseas doing nothing w

ould not be kÿlhng the m othes; but only letting her

d ie

. M o se

o ve

l, in killin

g th

e ch

ild , o

n e w

o u ld

b e

iII IIIIIU U

E ;IIt [/ÿIb

U IIÿ IU

I-ÿ--T Iÿ ÿ-'lllltl 1

1 0

.ÿ t..;..3 Illllllÿ

ted no clim e, and ss not aim

ing at hss m other's death.

A nd then there are a vatiety of w

ays in w hich this

m ight be continued. (a) B

ut as dnectly killing an inno- cent pelson IS

alw ays and absolutely sm

peim issible,

' an aboitlon m ay not be perform

ed O 1, (b) as dnectly

killin g a

n in

n o ce

n t p

e rso

n IS

m u Id

e r, a

n d m

u ld

e r is

alw ays and absolutely im

pelm lssthle, an abom

on m ay

n o t b

e p

e ifo

lm e d 4

O r, (C

) a s o

n e 's d

u ty to

ie fla

m from

directly killing an innocent pelson is m ole strin-

gent than one's duty to keep a peIson fiom dying, an

abortion m ay not be perfolm

ed O r, (d) If one's only

optsons are dnectly killsng an innocent pelson ol let- ting a person die, one m

ust pIefei letting the pesson die, and thus an abortion m

ay not be perform ed,s

S om

e people seem to have thought that these are

not fulther plem ises w

hich m ust be added if the con-

clusion is to be leached, but that they follow fi'om

the very fact that an innocent pelson has a right to hfe 6 B

ut this seem s to m

e to be a rm stake, and perhaps the

sim plest w

ay to show this is to bring out that w

hile w

e m ust certainly grant that innocent pelsons have a

light to hfe, the theses in (a) thlough (d) ale all false Take (b), for exam

ple. If directly killing an innocent peison IS

m urder, and thus is im

pelm isslble, then the

m o

th e

r's d ire

ctly killin g

th e

in n

o ce

n t p

e rso

n in

sid e

hel is m urder, and thus is Im

perm issible B

ut it cannot seriously be thought to be m

urder if the m othes pes-

form s an abortion on heiself to save her hfe. It cannot

seriously be sad that she m ust refialn, that she m

ust sit passively by and w

m t for her death. Let us look

a g a in

a t th

e ca

se o

f yo u a

n d th

e vio

lin ist T

h e le

yo u

a re

, m b

e d

w ith

th e

vlo h

n ist, a

n d

th e

d ire

cto r o

f th e

h o

sp ita

l sa ys to

yo u

, "It's a ll m

o st d

istle ssin

g , a

n d

I deeply sym

pathize, but you see this is putting an addi- tio

n a l stra

in o

n yo

u r kid

n e ys, a

n d yo

u 'll b

e d

e a d

w ithin the m

onth. B ut you have to stay w

heie you are a

ll th e

sa m

e . B

e ca

u se

u n

p lu

g g

in g

yo u

w o

u ld

b e

d ire

c tly

k illin

g a

n in

n o

c e

n t w

o h

n is

t, a n d

th a t's

m u

rd e

r, a n

d th

a t's Im

p e

rm issib

le " If a

n yth

in g

in th

e w

orld is true, it is that you do not com m

it m urder, you

do not do w hat is im

pesm lssible, if you leach alound

to youi back and unplug yourself fiom that vlohnlst

to save your life. T

h e

m a

in fo

cu s o

f a tte

n tio

n in

w iitm

g s o

n a

b o

r- tm

n has been on w hat a third party m

ay or m ay not

do In answ er to a ÿequest from

a w om

an for an abor- tio

n . T

h is ss in

a w

a y u

n d

e rsta

n d

a b

le T

h in

g s b

e in

g as they ale, thele isn't m

uch a w om

an can safely do to abolt hexself. S

o the question asked is w hat a thild

paity m ay do, and w

hat the m other m

ay do, if it is

ln e n

tm n e

d a

t a ll, is d

e d u ce

d , a

lm o

st a s a

n a

fte r-

th o

u g

h t, fro

m w

h a

t it is co n

clu d

e d

th a

t th u

d p

a rtie

s m

ay do. B ut it seem

s to m e that to tseat the m

atte1 m this w

ay ss to lefuse to gÿant to the m othei that veIy

status of pelson w hich ss so film

ly insisted on foÿ the fe

tu s. F

o r w

e ca

n n o t sim

p ly se

a d o

ff w h a t a

p e lso

n m

ay do flom w

hat a thiid paxty m ay do. S

uppose you find yourself tiapped m

a tsny house w sth a grow

ing ch

ild . I m

e a

n a

re ly tin

y h o

u se

, a n

d a

la p

ld ly g

lo w

- sng child--you m

e already up against the w all of the

house and in a few m

inutes you'll be m ushed to death

T h e ch

ild o

n th

e o

th e l h

a n d w

o n 't b

e clu

sh e d to

death; if nothing is done to stop him fiom

grow ing

he'll be hint, but in the end he'll sim ply bm

st open the house and w

alk out a free m an. N

ow I could w

ell u n d m

sta n d it if a

b ysta

n d e r w

e re

to sa

y, "T h e re

's nothing w

e can do for you. W e cannot choose betw

een yo

u r life

a n

d h

is, w e

ca n

n o

t b e

th e

o n

e s to

d e

cid e

w ho is to hve, w

e cannot intervene." B ut it cannot be

concluded that you too can do nothing, that you cannot attack it to save your life H

ow eves innocent the child

m a

y b e

, yo u

d o

n o

t h a

ve to

w a

it p a

ssive ly w

h ile

it crushes you to death P

erhaps a pregnant w om

an as vaguely felt to have the status of house, to w

hich w e

don't allow the right of self-defense. B

ut If the w om

an houses the child, st should be lem

em beled that she lS

a pelson w ho houses It.

I should pelhaps stop to say exphcltly that I am not

claim ing that people have a light to do anything w

hat- e ve

r to sa

ve th

e ir live

s. I th in

k, ia th

e l, th

a t th

e re

a le

dIastlc hm lts to the right of self-defense If som

eone ttueatens you w

ith death unless you tortuie som eone

else to death, I think you have not the light, even to save your life, to do so B

ut the case under consldeI- atlon here is vm

y diffm ent. In our case there are only

tw o people involved, one w

hose life is threatened, and one w

ho threatens It. B oth m

e innocent the one w ho

IS thleatened IS

not threatened because of any fault, the one w

ho threatens does not threaten because of a

n y fa

u lt F

o r th

is re a

so n

w e

m a

y fe e

l th a

t w e

bystandeIs cannot intervene. B ut the person threat-

e n e d ca

n .

In sum , a w

om an sulely can defend her life against

the thleat to it posed by the unbosn child, even if dosng so revolves its death. A

nd this show s not m

elely that the theses in (a) tbaough (d) are false; It show

s also that the extiem

e view of abortion is false, and so

w e need not canvass any other possible w

ays of am y-

m g at it flom

the argum ent I m

entioned at the outset

356 R E

P R

O D

U C

T IO

N

2 T he extlem

e view could of C

O U

lS e be w

eakened to

sa y th

a t w

h ile

a b o ltio

n is p

e rm

issib le

to sa

ve th

e m

other's life, it m ay not be petfolm

ed by a thxld palty, but only by the m

othel herself B ut this cannot be

right elthel. F oi w

hat w e have to keep in m

ind is that the m

other and the unborn child ale not like tw o ten-

a n

ts in a

sm a

ll h o

u se

w h

ich h

a s, b

y a n

u n

fo ltu

n a

te m

ista ke

, b e e n le

n te

d to

b o th

th e m

o th

e l o

w n s th

e house. T

he fact that she does adds to the offensive- ness of deducing that the m

other can do nothing from the supposition that thud parties can do nothing. B

ut It does m

ore than this it casts a bnght light on the supposition that thu'd parties can do nothing. C

eltalnly it le

ts u s se

e th

a t a

th u d p

a lty w

h o sa

ys "I ca n n o t

choose betw een you" is fooling him

self if he thinks this is Im

partiality If Jones has found and fastened on a celtain coat, w

hich he needs to keep him from

freez- In

g , b

u t w

h ich

S m

ith a

lso n

e e d s to

ke e p h

im fro

m fleezing, then it is not llnpaltiallty that says "I cannot ch

o o

se b

e tw

e e

n yo

u " w

h e

n S

in lth

o w

n s th

e co

a t

W om

en have said again and again "T his body is m

y bodyP

' and they have leason to feel angly, leason to feel that it has been like shouting into the w

ind. S rm

th, after all, is haldly likely to bless us if w

e say to him ,

"O f course it's youl coat, anybody w

ould giant that It

is B u

t n o

o n

e m

a y ch

o o

se b

e tw

e e

n yo

n a

n d

Jo n

e s

w h

o is to

h a

ve it"

W e should ieally ask w

hat it is that says "no one m

ay choose" in the face of the fact that the body that houses the child is the m

othel's body. It m ay be

sim ply a faIluie to appreciate this fact. B

ut it m ay be

som ething m

ore Interesting, nam ely, the sense that

one has anght to refuse to lay hands on people, even w

hele it w ould be just and fair to do so, even w

here ju

stice se

e m

s to le

q u u e th

a t so

m e b o d y d

o so

T h u s

ju stice

m ig

h t ca

ll fo i so

m e b o d y to

g e t S

m ith

's co a t

b a

ck flo m

Jo n

e s, a

n d

ye t yo

u h

a ve

a n

g h

t to le

fu se

to be the one to lay hands on Jones, a light to Iefuse to

d o

p h

ysica l vio

le n

ce to

h im

. T h

is, I th in

k, m u

st b

e g

lin te

d . B

u t th

e n

w h

a t sh

o u

ld b

e sa

id is n

o t "n

o o n e m

a y ch

o o se

," b u t o

n ly "I ca

n n o t ch

o o se

," a n d

In d e e d n

o t e

ve n th

is, h u t "I w

ill n o t a

ct," le a vin

g it

open that som ebody else can or should, and in par-

tlcular that anyone in a position of authoiity, w ith the

job of securing people's nghts, both can and should S

o this is no difficulty. I have not been algulng that a

n y g

ive n

th n

d p

a rty m

u st a

cce d

e to

th e

m o

th e

l's lequest that he preform

an abortion to save hm hfe.

I su p p o se

th a t in

so m

e vie

w s o

f h u m

a n life

th e

m o

th e

l's b o

d y is o

n ly o

n lo

a n

to h

e i, th

e lo

a n

n o

t b

e in

g o

n e

w h

ich g

ive s h

e i a

n y p

rio r cla

im to

it O n

e w

ho held this view m

ight w ell think it Im

partlahty to sa

y "I ca n n o t ch

o o se

" B u t I sh

a ll sim

p ly ig

n o re

th is

possibility. M y ow

n view is that if a hum

an being has any just, pnor claim

to anything at all, he has a JU S

t, puor claim

to his ow n body. A

nd perhaps this needn't be algued for hele anyw

ay, since, as I m entioned, the

argum ents against aboltlon w

e ale looking at do giant that the w

om an has a right to decide w

hat happens in and to her body

B ut although they do grant It, I have tried to show

that they do not take seriously w hat is done in giant-

in g it I su

g g e st th

e sa

m e th

in g w

ill le a p p e a r e

ve n

m ole clearly w

hen w e turn aw

ay flora cases in w hich

the m othel's life is at stake, and attend, as I pIopose

w e now

do, to the vastly m ore com

m on cases in w

hich a

w o

m a

n w

a n

ts a n

a b

o rtio

n fo

r so m

e le

ss w e

ig h

ty Ieason than pleselvIng hel ow

n life 3. W

heie the m other's hfe is not at stake, the argu-

m ent I m

entioned at the outset seem s to have a m

uch S

tlo n

g e

l p u

ll. "E ve

lyo n

e h

a s a

u g

h t to

h fe

, so th

e unboin person has a right to life." A

nd isn't the child's right to life w

eightier than anything othei than the m

o th

e r's o

w n

n g

h t to

life , w

h ich

sh e

m ig

h t p

u t fo

r- w

aId as gIound for an abortion9

T h is a

Ig u m

e n t tle

a ts th

e lig

h t to

life a

s if it w e le

unproblem atlc. It is not, and this seem

s to m e to be

precisely the souice of the m istake.

F ol w

e should now , at long last, ask w

hat it com es

to, to have a nght to life. In som e view

s having a right to life includes having a right to be given at least the bare m

inim um

one needs foi continued life. B ut sup-

p o se

th a t w

h a t in

fa ct ts th

e b

a le

m in

im u m

a m

a n

needs foi continued life is som ething he has no right

at all to be given. If I am sick unto death, and the only

thing that w ill save m

y life is the touch of H enry

F o n d a 's co

o l h

a n d o

n m

y fe ve

le d b

lo w

, th e n a

ll th e

sam e, I have no right to be given the touch of H

enry F

o n d a 's co

o l h

a n d o

n m

y fe ve

re d b

io w

. It w o u ld

b e

fiIghtfully nice of him to fly in from

the W est C

oast to

p ro

vid e it It w

o u ld

b e le

ss ra ce

, th o u g h n

o d

o u b t

w ell m

eant, if m y friends flew

out to the W est C

oast and calned H

eniy Fonda back w ith them

B ut I have

no right at all against anybody that he should do this fo

r m e O

r a g a in

, to le

tu rn

to th

e S

tO ly I to

ld e

a rlie

r, the fact that for continued life that vlohnlst needs the continued use of you1 kidneys does not establish that h e h

a s a

n c rh

t tn h

o c

, ..... ÿ r, .......... a

..... c _

you should give him continued use of youi kidneys.

F ol nobody has any right to use youi kidneys unless

you give him such a right, and nobody has the right

a g

a in

st yo u

th a

t yo u

sh a

ll g ive

h im

th is fig

h t--if yo

u d o a

llo w

h im

to g

o o

n u

sin g yo

u i kid

n e ys, th

is is a kindness on your part, and not som

ething he can claim from

you as his due. N oi has he any nght against any-

body else that they should give him continued use of

your kidneys C ertainly he had no light against the

S ociety of M

usic Lovels that they should plug hnn into you in the fiist place A

nd if you now stait to

u n p lu

g yo

u rse

lf, h a vin

g le

a ln

e d th

a t yo

u w

ill o th

e i-

w ise have to spend nine yeals in bed w

ith him , thele

is n o b o d y in

th e w

o rld

w h o m

u st tiy to

p ie

ve n t yo

u ,

In oidel to see to it that he is given som ething he has

a right to be given S

om e people am

lather stlIctm about the right to

life. In their view , it does not include the right to be

given anything, but am ounts to, and only to, the fight

not to be killed by anybody B ut hele a lelated diffi-

culty arises If evelybody is to refrain fiom kilhng

that violinist, then evelybody m ust lefialn fiom

doing a gleat m

any different sorts of things E velybody m

ust m

fiam flora slitting his thloat, evelybody m

ust refialn flo

ra sh

o o

tin g

h im

--a n

d e

ve lyb

o d

y m u

st le fia

ln flo

m unplugging you fi'om

hun B ut does he have a light

against eveiybody that they shall refiain fiom unplug-

ging you flora him ? T

o iefialn flora doing this is to allow

him to continue to use youl kidneys. It could be

argued that he has a right against us that w e should

a llo

w h

im to

co n tin

u e to

u se

yo u r kid

n e ys T

h a t is,

w hile he had no nght against us that w

e should give him

the use of youl kidneys, it m ight be aigued that

he anyw ay has a right against us that w

e shall not now intervene and deprive him

of the use of youl kidneys I sh

a ll co

m e b

a ck to

th ild

-p a lty in

te lve

n tio

n s la

te r

B u t ce

lta ln

ly th e vlo

h n lst h

a s n

o u

g h t a

g a in

st yo u

that you shall allow him

to continue to use your lud- neys A

s I said, if you do allow him

to use them , it is

a kindness on youl part, and not som ething you ow

e himThe difficulty I point to here IS

not peculiar to the rig

h t to

life It le

a p p e a rs in

co n n e ctio

n w

ith a

ll th e

othel natulal rights; and it 1s som ething w

hich an ade- q u a te

a cco

u n t o

f rig h ts m

u st d

e a l w

ith F

o r p

le se

n t

p ro

p o se

s it is e n o u g h ju

st to d

ia w

a tte

n tio

n to

it B u t

I w ould stress that I am

not arguing that people do not have a right to hfe--qm

te to the contlaiy, it seem s to

m e th

a t th

e p

rim a ry co

n tlo

l w e m

u st p

la ce

o n th

e o

1 . . ,1

. , 1

JU D

IT H

JA R

V IS

T H

O M

S O

N 357

h a

ve a

rig h

t to life

I a m

a rg

u in

g o

n ly th

a t h

a vin

g a

u g h t to

life d

o e s n

o t g

u a Ia

n te

e h

a vin

g e

lth e l a

rig h t

to be given the use of oi a right to be allow ed contin-

ued use of anothel pelson's body--even if one needs it fo

i life itse

lf. S o

th e

n g

h t to

life w

ill n o

t se lve

th e

o p

p o

n e

n ts o

f a b

o itlo

n in

th e

ve ry sim

p le

a n

d cle

a i

w ay in w

hich they seem to have thought It w

ould. 4

T h

e re

is a n

o th

e i w

a y to

b rin

g o

u t th

e d

ifficu lty.

In the m ost oldlnary sort of case, to deprive som

eone o

f w h

a t h

e h

a s a

rig h

t to IS

to tre

a t h

im u

n ju

stly. S

uppose a boy and his sm all blothel ale jointly given

a box of chocolates for C hnstm

as If the older boy ta

ke s th

e b

o x a

n d

le fu

se s to

g ive

h is b

lo th

e r a

n y o

f the chocolates, he is unjust to him

, for the blother has been given a right to half of them

B ut suppose that,

having learned that othelw ase it m

eans nine years in bed w

ith that vlohnlst, you unplug youlself from him

Y o

u su

re ly a

le n

o t b

e in

g u

n ju

st to h

im fo

l yo u

g a

ve him

no right to use youl kidneys, and no one else can have given him

any such ught B ut w

e have to notice that in unplugging yom

self, you ale lulhng him ; and

vlohm sts, like everybody else, have a right to life, and

th u

s in th

e vie

w w

e w

e le

co n

sid e

rin g

ju st n

o w

, th e

rig h t n

o t to

b e lu

lle d . S

o h

e le

yo u d

o w

h a t h

e su

p -

posedly has a right you shall not do, but you do not act unjustly to him

in doing it T

he em endation w

hich m ay be m

ade at this point is this: the right to life consists not in the right not to be lulled, but lathel in the right not to be lulled unjustly. T

his luns a risk of clrculallty, but never m ind

it w ould enable us to squate the fact that the violinist

has a right to hfe w ith the fact that you do not act

unjustly tow ard him

in unplugging yourself, theleby killing him

. F or ff you do not kill him

unjustly, you do not violate his right to life, and so it is no w

ondel you do him

no injustice. B

ut If this em endation is accepted, the gap in the

argum ent against aboltlon stares us plainly in the face

It is by no m eans enough to show

that the fetus is a pelson, and to lem

lnd us that all peisons have a right to

life --w

e n

e e d to

b e sh

o w

n a

lso th

a t kilh

n g th

e fe

tu s vio

la te

s its lig h

t to life

, 1 .e

, th a

t a b

o itlo

n is

unjust killing A nd is it?

I suppose w e m

ay take it as a datum that m

a case of plegnancy due to rape the m

othel has not given the unboin person a right to the use of hei body for food a n d sh

e lte

r. In d e e d , in

w h a t p

re g n a n cy co

u ld

it b e

,1 1

_

3 5 ÿ R E

P R

O D

U C

TIO N

drifting about the w orld, to w

hom a w

om an w

ho w ants

a ch

]ld sa

ys "I in vite

yo u m

"

B ut it m

ight be algued that thele ale other w ays one

can have acqun'ed anght to the use of anothei peison's body than by having been lnw

ted to use It by that person S

uppose a w om

an voluntarily Indulges in inter- co

u ise

, kn o

w in

g o

f th e

ch a

n ce

it w ill Issu

e In

p le

g -

nancy, and then she does becom e pIegnant; is she not

in p

a st re

sp o n sib

le fo

l th e p

le se

n ce

, in fa

ct th e ve

iy existence, of the unboln person inside her? N

o doubt she did not Invite it in. B

ut doesn't hel paitlal lespon- sibillty for its being there itself give it anght to the use of her body?7 If so, then her aboiting it w

ould be m

ole like the boy's taking aw ay the chocolates, and

less like your unplugging youlself fi'om the violinist--

doing so w ould be depnvm

g it of w hat it does have a

nght to, and thus w ould be doing it an InJU

S tice.

A nd then, too, it m

ight be asked w hethel or not she

ca n

kill it e ve

n to

sa ve

h e

i o w

n life

: If sh e

vo lu

n ta

i- Ily called it Into existence, how

can she now 1,:111 it,

even In self-defense9

T he first thing to be said about this is that it is

som ething new

O pponents of aboltion have been so

concerned to m ake out the Independence of the fetus,

m oIdm

to establish that it has a right to life, just as its m

other does, that they have tended to ovm look the

possible support they m ight gain flom

m aking out

that the fetus 15 dependent on the m othm

, m order to

establish that she has a special kind of responsibility for st, a Iesponslbahty that gw

es it rights against her w

hich m e not possessed by any independent person--

such as an ailing violinist w ho is a strangei to her.

O n the other hand, this argum

ent w ould gave the

unboln pelson a Iaght to its m other's body only ff hel

p le

g n

a n

cy le su

lte d

fio m

a vo

lu n

ta iy a

ct, u n

d e

ita ke

n an fnll know

ledge of the chance a pregnancy m ight

le su

lt flo ra

it. It w o u ld

le a ve

o u t e

n O

re ly th

e u

n b o ln

pelson w hose existence as due to Iape. P

ending the avaIlabihty of som

e fuIther aIgum ent, then, w

e w ould

be left w ath the conclusion that unborn peIsons w

hose e xiste

n ce

is d u e to

ra p e h

a ve

n o rig

h t to

th e u

se o

f then m

otheIs' bodies, and thus that abolting them is

not depriving them of anything they have a right to

and hence IS not unjust killing

A nd w

e should also notm e that st is not at all plain

that this argum ent really does go even as fm

as it pur- polts to. F

oi there ale cases and cases, and the details snake a dlffelence. If the room

is stuffy, and I these- fore open a w

indow to aii st, and a bm

glar clim bs m

,

it w ould be absm

d to say, "A h, now

he can stay, she's given him

a light to the use of hel house--foa she is p a rtia

lly Ie sp

o n sa

b le

fo l h

is p le

se n ce

th e re

, h a vin

g vo

lu n ta

rily d o n e w

h a t e

n a b le

d h

im to

g e t In

, in fu

ll know

ledge that thele are such things as buiglm s, and

that burglaIs buigle." It w ould be stall m

ole absurd to sa

y th is if I h

a d h

a d b

a ls In

sta lle

d o

u tsid

e m

y w in

- d o w

s, p re

cise ly to

p re

ve n t b

u lg

la rs fi'o

m g

e ttin

g in

, and a buIglar got in only because of a defect m

the bais. It rem

ains equally absurd if w e im

agine it is not a bulglar w

ho chm bs in, but an innocent person w

ho blundeis o1" falls in A

gain, suppose it w ine like this:

people-seeds drift about m the an like pollen, and if

yo u o

p e n yo

u r w

in d o w

s, o n e m

a y d

rift m a

n d ta

ke m

ot in yore carpets or upholstery. Y ou don't w

ant chil- d

re n

, so yo

u fix u

p yo

u r w

in d

o w

s w ith

fin e

m e

sh sm

eens, the vm y best you can buy. A

s can happen, how

evei, and on vm y, very rale occasm

ns does happen, one of the screens is defective; and a seed drifts m

and takes IO

O t D

oes the person-plant w ho now

develops h

a ve

a rig

h t to

th e

u se

o f yo

u r h

o u

se ?

S u

re ly n

o t--

despite the fact that you voluntaraly opened your w in-

dow s, you know

ingly kept carpets and upholstm ed

furm tule, and you knew

that screens w ere som

etim es

defective S om

eone m ay algue that you are aesponsa-

b le

fo r its lO

O tin

g , th

a t st d

o e s h

a ve

a rig

h t to

yo re

house, because after all you could have lived out your life w

ath bare floors and fulniture, or w ith sealed w

in- d

o w

s a n

d d

o o

Is B u

t th is w

o n

't d o

--fo r b

y th e

sa m

e token anyone can avoad a pregnancy due to Iape by havang a hysterectom

y, o2 anyw ay by never leaving

hom e w

ithout a (rehablel) alm y

It seem s to m

e that the algum ent w

e w ere looking

at can establish at m ost that there are som

e cases m w

hm h the unborn pm

son has a right to the use of its m

o th

e r's b

o d y, a

n d th

e re

fo re

so m

e ca

se s in

w h ich

aboltion as unjust kllhng. T hem

IS room

foI m uch dis-

cussion and m gum

ent as to precisely w hich, ]f any.

B ut I thank w

e should sadestep this issue and leave it open, fol at any rate the algum

ent certainly does not estabhsh that all aboltion as unjust kdlllng

5 T

h e re

is zo o m

fo i ye

t a n o th

e r a

Ig u m

e n t h

e re

, how

ever W e sm

ely m ust all grant that there m

ay be cases in w

hich st w ould be m

olally indecent to detach a pm

son flora yore body at the cost of his hfe. Suppose yo

u le

a rn

th a t w

h a t th

e vm

lim st n

e e d s a

s n o t n

in e

years of youi life, but only one houi. A ll you need do

to save his life is to spend one horn In that bed w ath

him S

uppose also that letting him use your kidneys

foi that one horn w ould not affect your health an the

slig h te

st A d m

itte d ly yo

u w

e re

kla ,ÿ,,,,ÿa

A ,4

...... m ..

you did not give anyone perm issm

n to plug him into

you. N evertheless it seem

s to m e plain you ought to

allow him

to use your kidneys for that hour--it w ould

be indecent to refuse. A

gain, suppose pregnancy lasted only an houl, and co

n stitu

te d n

o th

le a t to

h fe

o r h

e a lth

A n d su

p p o se

that a w om

an becom es pregnant as a result of lape.

A dm

ittedly she did not voluntarily do anything to bring about the existence of a child. A

dm attedly she

did nothing at all w hich w

ould give the unboln person a light to the use of her body. A

ll the sam e it m

ight w

ell be said, as in the new ly em

ended violinist story, that she ought to allow

it to rem ain foi that houl--that

it w ould be indecent an her to refuse. N

ow som

e people m e inclined to use the term

"right" in such a w

ay that st follow s from

the fact that you ought to allow

a person to use your body for the houI he needs, that he has a right to use your body fol the houI he needs, even though he has not been given that right by any person or act. They m

ay say that it follow s

also that ff you refuse, you act unjustly tow ard him

. T

h is u

se o

f th e te

Im a

s p e rh

a p s so

co m

m o n th

a t it

cannot be called w rong, nevertheless it seem

s to m e to

be an unfoatunate loosening of w hat w

e w ould do better

to keep a tight 1era on. S uppose that box of chocolates

I m entm

ned earher had not been given to both boys jointly, but w

as given only to the older boy. There he sits, stolidly eating his w

ay through the box, his sm all

brother w atching enviously. H

ere w e are likely to say

"Y ou ought not to be so m

ean. Y ou ought to give yore

bxothm som

e of those chocolates." M y ow

n view IS

that it just does not follow

from the truth of this that the

blother has any right to any of the chocolates If the boy refuses to give his brothm

any, he as gIeedy, stingy, ca

llo u s--b

u t n

o t u

n ju

st I su p p o se

th a t th

e p

e o p le

I have in rm

nd w ill say It does follow

that the brothel has a fight to som

e of the chocolates, and thus that the boy does act unjustly If he refuses to give has brother any B

ut the effect of saying this is to obscule w hat w

e should keep distinct, nam

ely the dlffeaence betw een the

boy's refusal in this case and the boy's refusal in the earlier case, in w

hich the box w as given to both boys

jointly, and in w hich the sm

all brother thus had w hat

w as fi'om

any point of view clem

txtle to half. A

further objection to so using the team "right"

that fiom the fact that A

ought to do a thing for B , it

follow s that B

has a right against A that A

do it foi him

, is that it is going to m ake the question of w

hether o2 not a m

an has a right to a thing turn on how easy

it is to provide him w

ath it; and this seem s not m

eIely _

1 _

1 _

re _

l_ _

ÿ1 ......

JU D

IT H

JA R

V IS

T H

O M

S O

N 359

of H em

y Fonda again. I said eallier that I had no right to

th e

to u

ch o

f h is co

o l h

a n

d o

n m

y le ve

le d

b lo

w ,

even though I needed it to save m y life I said it w

ould be frightfully nice of him

to fly in from the W

est C oast

to plovade m e w

ith It, but that I had no right against him

that he should do so B ut suppose he asn't on the

W est C

oast S uppose he has only to w

alk across the lo

o m

, p la

ce a

h a

n d

b rie

fly o n

m y b

ro w

--a n

d lo

, m y

h fe

is sa ve

d . T

h e

n su

re ly h

e o

u g

h t to

d o

it, it w o

u ld

be indecent to lefuse Is st to be stud "A h w

ell, it fol- low

s that in this case she has a right to the touch of his hand on hm

brow , and so it w

ould be an InJustice in him

to refuse"9 S o that I have a right to it w

hen it is easy for ham

to provide st, though no right w hen it's

h a

rd 9

It's ra th

e l a

sh o

ckin g

id e

a th

a t a

n yo

n e

's iig h

t should fade aw

ay and disappear as it gets haldei and haldel to accord them

to him .

S o m

y ow n view

IS that even though you ought to

let the violim st use your kidneys foi the one hour he

needs, w e should not conclude that he has a right to

do so--w e w

ould say that if you refuse, you ale, like the boy w

ho ow ns all the chocolates and w

ill give none aw

ay, self-centered and callous, indecent in fact, but not unjust. A

nd S lm

llally, that even supposing a case in w

hich a w om

an plegnant due to lape ought to allow

the unboin person to use her body for the houi he needs, w

e should not conclude that he has a right to do so; w

e should conclude that she is self-centm ed,

callous, indecent, but not unjust, if she refuses T he

co m

p la

in ts a

le n

o le

ss g la

ve , th

e y m

e ju

st d lffe

Ie n

t H

o w

e ve

r, th e le

is n o n

e e d to

in sist o

n th

is p o in

t If a

n yo

n e

d o

e s w

a sh

to d

e d

u ce

"h e

h a

s a rig

h t" flo

m "yo

u o

u g h t," th

e n a

ll th e sa

m e h

e m

u st su

le ly g

ia n t

that there aie cases in w hich it is not m

orally lequim d

o f yo

u th

a t yo

u a

llo w

th a

t vlo h

n lst to

u se

yo u

i kid -

n e

ys, a n

d in

w h

ich h

e d

o e

s n o

t h a

ve a

rig h

t to u

se them

, and in w hich you do not do ham

an injustice if you refuse A

nd so also foa m othel and unboin child.

E xcept in such cases as the unborn pelson has a right

to dem and st--and w

e w ere leaving open the possi-

bility that them m

ay be such cases--nobody as m olally

le q

u tre

d to

m a

ke la

lg e

sa crifice

s, o f h

e a

lth , o

f a ll

other interests and concerns, of all othm duties and

com m

itm ents, for nine yeats, or even for nine m

onths, in oldm

to keep another person ahve 6. W

e have m fact to distinguish betw

een tw o kinds

of S am

aritan: the G ood S

am aritan and w

hat w e m

ight call the M

inim ally D

ecent S am

aritan. T he stoxy of the

3130 R E

P R

O D

U C

TIO N

A ce

rta in

m a

n w

e n

t d o

w n

flo ra

Je ru

sa le

m to

Je llch

o ,

and fell am ong thieves, w

hich stlm pped him

of his lalm ent,

and w ounded him

, and depm ted, leaving ham

half dead A

n d

b y ch

a n

ce th

e le

ca m

e d

o w

n a

ce lta

ln p

lle st th

a t

w ay, and w

hen he saw hnn, he passed by on the othel side

A n d like

w ise

a L

e vite

, w h e n h

e w

a s a

t th e p

la ce

, ca m

e and looked on him

, and passed by on the otheÿ side B

ut a celtaln S am

alltan, as he jom neyed, cam

e w hele he

w as, and w

hen he saw hÿm

he had com passion on him

A n d w

e n t to

h im

, a n d b

o u n d u

p h

is w o u n d s, p

O u lln

g m

o11 and w ine, and set him

on his ow n beast, and N

ought him to

a n

in n

, a n

d to

o k ca

le o

f h im

A nd on the m

onow , w

hen he depalted, he took out tw o

pence, and gave them to the host, and said unto him

, "T ake

cm e

o f h

ÿm , a

n d

w h

a tso

e ve

l th o

u sp

e n

d e

st m o

ÿe , w

h e

n I

co m

e a

g a

in , I w

ill re p

a y th

e e

"

(Luke 10 30-35)

T h e G

o o d S

a m

a Ilta

n w

e n t o

u t o

f h is w

a y, a

t so m

e cost to him

self, to help one in need of it W e are not

told w hat the options w

ere, that is, w hethel oi not the

priest and the Levite could have helped by doing less than the G

ood Sam m

itan did, but assum ing they could

have, then the fact they did nothing at all show s they

w e le

n o t e

ve n M

in im

a lly D

e ce

n t S

a m

a rita

n s, n

o t

because they w ele not S

am aritans, but because they

w ere not even m

inim ally decent.

T hese things are a m

attel of degree, of course, but theie is a difference, and it com

es out peihaps m ost

cle a

ily in th

e sto

ry o f K

itty G e

n o

ve se

, w h

o , a

s yo u

w ill lem

em ber, w

as m uideled w

hile thirty-eight people w

atched oi listened, and did nothing at all to help her A

G o o d S

a m

a rita

n w

o u ld

h a ve

ru sh

e d o

u t to

g ive

diIect assistance against the m uidereI. O

I pelhaps w e

had bettel allow that it w

ould have been a S plendid

S am

aritan w ho did this, on the ground that It w

ould h a ve

In vo

lve d a

iisk o f d

e a th

fo I h

im se

lf. B u t th

e thirty-eight not only did not do this, they did not even tiouble to pick up a phone to call the police. M

inim ally

D ecent S

am m

itanism w

ould call foi doing at least that, and their not having done It w

as m onstrous.

A fter telling the stoiy of the G

ood S am

aiItan, Jesus said, "G

o, and do thou likew ise." P

eihaps he m eant that

w e are m

olally lequired to act as the G ood S

am aritan

did. P elhaps he w

as ulgxng people to do m oie than is

m orally iequned of them

A t all events it seem

s plain that it w

as not m oIally requned of any of the thirty-

eight that he lush out to give dnect assistance at the IIsk of his ow

n fife, and that It is not m oially required

of anyone that he give long stietches of his life--nine ye

a is O

l n in

e m

o n th

s--to su

sta in

in g th

e life

o f a

p e lso

n w

h o h

a s n

o sp

e cia

l iig h t (w

e w

e ie

le a vin

ÿ o

p e

n th

e p

o ssib

ility o f th

is) to d

e m

a n

d it.ÿ>

ÿ Indeed, w

ith one rathei striking class of exceptions, no one in any countiy in the w

orld is legally Iequired to do anyw

heie near as m uch as this for anyone else.

T he class of exceptions is obvious M

y m ain concern

heie is not the state of the law in aespect to abortion,

but It is w orth diaw

lng attention to the fact that in no state an this countiy IS

any m an com

pelled by law to be

e ve

n a

M in

im a lly D

e ce

n t S

a m

m lta

n to

a n y p

e rso

n ,

theie is no law undei w

hich charges could be biought against the thnty-eight w

ho stood by w hile K

itty G

enovese died B y contrast, in m

ost states in this coun- try w

o m

e n

a re

co m

p e

lle d

b y la

w to

b e

n o

t m e

ie ly

M inim

ally D ecent S

am aritans, but G

ood S am

aritans to unboln pelsons inside them

T his doesn't by Itself settle

anything one w ay oI the other, because it m

ay w ell be

rogued that there should be law s in this countty--as

there are in m any E

ulopean countrIes--com pelhng at

le a st M

in im

a lly D

e ce

n t S

a m

a iita

n ism

.s B u t it d

o e s

show that theie is a gIoss Injustice in the existing state

of the law A

nd it show s also that the gIoups cunently

w orking against liberalization of abortion law

s, in fact w

orking tow ald having It declared unconstitutional for

a state to peIm lt abortion, had better stait w

oiklng for the adoption of G

ood S am

aritan law s geneially, O

l earn the charge that they aie acting in bad faith

I should think, m yself, that M

inim ally D

ecent S

am alatan law

s w ould be one thing, G

ood S am

aritan law

s quite another, and in fact highly im proper B

ut w e

are not heie conceined w ith the law

W hat w

e should ask is not w

hethel anybody should be com pelled by law

to be a G ood S

am aritan, but w

hether w e m

ust accede to a situation in w

hich som ebody is being com

pelled-- by natuie, perhaps--to be a G

ood S am

autan. W e have,

in othei w oids, to look now

at thnd-pm 'ty antelventlons.

I have been arguing that no pelson is m olally requiled

to m ake large saclifices to sustain the life of another

w ho has no right to dem

and them , and this even w

heIe the sacrifices do not include life itself; w

e are not m

o ra

lly Ie q u n e d to

b e G

o o d S

a m

a iita

n s o

r a n yw

a y

V ely G

ood S am

aritans to one another. B ut w

hat if a m

an cannot extricate him self from

such a situation? W

hat If he appeals to us to extricate hlm 9 It seem

s to m

e plain that theie are cases in w hich w

e can, cases In w

hich a G ood S

am m

'itan w ould extricate him

. T heie

you ale, you w ere kidnapped, and nine yeals in bed

w ith that violinist lie ahead of you Y

ou have youl ow n

life to lead. Y ou axe sony, but you sim

ply cannot see giving up so m

uch of youi life to the sustaining of his. Y

o u

ca n

n o

t e xtrica

te yo

u lse

lf, a n

d a

sk u s to

d o

so

,u ld

h a v e th

o u g h t th

a t--in

lig h t o

f h is

ÿ right to the use of youi body--It w

as obvious that w e

do not have to accede to youi being foiced to give up so m

uch. W e can do w

hat you ask. T here is no injus-

tice to the vlolim st in om

doing so. 7. F

ollow ing the lead of the opponents of aboition,

I have thloughout been speaking of the fetus m eiely

as a pelson, and w hat I have been asking IS

w hethei

or not the m gum

ent w e began w

ith, w hich pIoceeds

only flora the fetus's being a pelson, ieally does estab- lish ItS

conclusion I have argued that it does not B

ut of couise theie aie aigum ents and argum

ents, and it m

ay be said that I have sim ply fastened on the

w io

n g

o n

e It m

a y b

e sa

id th

a t w

h a

t a s lm

p o

ita n

t a s

not m eIely the fact that the fetus as a peison, but that

it is a peison fol w hom

the w om

an has a special kind of IesponslbIhty IS

S uing fiom

the fact that she is its m

other A nd it m

ight be argued that all m y analogies

aie theiefole nrelevant--foI you do not have that spe- cial kind of lesponslbility for that violinist, H

eniy F

onda does not have that special kind of iesponslbi1- ity fo

x m e . A

n d o

u r a

tte n tio

n m

ig h t b

e d

ra w

n to

th e

fact that m en and w

om en both ate com

pelled by law to

p lo

vld e su

p p o lt fo

r th e u ch

lld ie

n .

I have in effect dealt (blIefly) w ith this aigum

ent in section 4 above, but a (still brlefei) iecapitulatlon now m

ay be in older. S urely w

e do not have any such "spe- cial responslbihty" for a peIson unless w

e have assum ed

it, explicitly oi im plicitly If a set of parents do not try

to prevent pregnancy, do not obtain an aboltlO n, and

then at the tim e of birth of the child do not put it out

for adoption, but rathei take it hom e w

ith them , then

they have assum ed lesponsiblhty fol it, they have given

it rights, and they cannot now w

lthdiaw suppoit fiom

it at the cost of its hfe because they now find it diffi-

cult to go on providing fol It B ut if they have taken all

ieasonable precautions against having a child, they do not sim

ply by vlItU e of theil biological ielationshIp to

th e ch

ild w

h o co

m e s in

to e

xiste n ce

h a ve

a sp

e cia

l iesponslbIhty foi it T

hey m ay w

ish to assum e Iespon-

slblllty for it, O l they m

ay not w ish to. A

nd I am sug-

gesting that If assuim ng iesponsablhty fol it w

ould requne laige sacrifices, then they m

ay refuse. A good

S am

aritan w ould not lefuse--or anyw

ay, a S plendid

S am

aritan, if the sacrifices that had to be m ade w

ele enorm

ous. B ut then so w

ould a G ood S

am alltan assum

e responsibility fol that viohnlst, so w

ould H enly F

onda, if he is a G

ood S am

aritan, fly in fiom the W

est C oast

and assum e lesponslbIllty fol m

e. 8 M

y m gum

ent w ill be found unsatIsfactoiy on tw

o counts by m

any of those w ho w

ant to legm d abortion

JU D

IT H

JA R

V IS

T H

O M

S O

N ÿ3o •

a s m

o ia

lly p e

lm lS

slb le

F irst, w

h ile

I d o

a ig

u e

th a

t aboItIO

n is not im perim

sslble, I do not rogue that it is alw

ays peim lssable T

hele m ay w

ell be cases an w hich

ca iiyln

g th

e ch

ild to

te lm

le q

u lle

S o

n ly M

in im

a lly

D ecent S

am aIitanIsm

of the m othei, and this IS

a stan- d a d w

e m

u st n

o t fa

ll b e lo

w I a

m in

clin e d to

th in

k it a m

erit of m y account pieclsely that it does not give a

geneIal yes oi a geneial no. It allow s fol and suppoits

o u i se

n se

th a t, fo

r e xa

m p le

, a sick a

n d d

e sp

e la

te ly

frightened fourteen-year-old schoolgnl, pregnant due to 1ape, m

ay of course choose aboitlon, and that any la

w w

h ich

lu le

s th is o

u t is a

n in

sa n e la

w A

n d it a

lso allow

s for and suppoits O U

l sense that in other cases iesolt to aboltlO

n is even positively indecent. It w ould

be indecent in the w om

an to iequest an aboltlon, and indecent in a doctor to perform

it, if she IS in her sev-

enth m onth and w

ants the aboltIO n just to avoid the

n u

isa n

ce o

f p o

stp o

n in

g a

trip a

b io

a d

T h

e ve

Iy fa ct

that the argum ents I have been diaw

ing attention to tieat all cases of abortion, O

l even all cases of aboltion an w

hich the m other's life IS

not at stake, as m orally

on a pal ought to have m ade them

suspect at the outset. S

econdly, w hile I am

alguIng fol the perm issibility

o f a

b o ltlO

n In

so m

e ca

se s, I a

m n

o t a

lg u In

g fo

r th e

right to secule the death of the unboln child It is easy to confuse these tw

o things In that up to a ceitaln point in the life of the fetus It as not able to suIvive outside the m

other's body; hence Iem ovlng it fiom

heI body g

u a

la n

te e

s its d e

a th

B u

t th e

y a le

im p

o rta

n tly d

iffe i-

ent I have argued that you ale not m orally iequned to

spend nine m onths in bed, sustaining the life of that

violinist, but to say this is by no m eans to say that If,

w hen you unplug yourself, thele is a m

liacle and he S

U lV

lV eS

, you then have a right to tuln alound and slit his thioat Y

ou m ay detach youlself even if this costs

h im

h is life

, yo u h

a ve

n o rig

h t to

b e g

u a ia

n te

e d h

is death, by som

e other m eans, if unplugging yourself

does not kill him Theie aie som

e people w ho w

ill feel dissatisfied by this featule of m

y algum ent A

w om

an m

ay be utteily devastated by the thought of a child, a bit of herself, put out for adoption and nevel seen oi h

e a

ld o

f a g

a in

S h

e m

a y th

e le

fo le

w a

n t n

o t m

e Ie

ly that the child be detached from

heI, but m oIe, that it

die S om

e opponents of aboltion are inclined to iegald this as beneath contem

pt--theIeby show ing insensitiv-

ity to w hat is sulely a pow

eiful source of despair. A ll

the sam e, I agree that the desne foi the child's death

is not one w hich anybody m

ay giatffy, should it tuin out to be possible to detach the child alive.

A t this place, how

ever, It should be lem em

bered that w

e have only been pretending tinoughout that the fetus IS

a hum an being from

the m om

ent of conception A very early abortion as suiely not the killing of a person, and so IS not dealt w

ith by anythm g I have said hele

N O

TES

1 I am vely m

uch indebted to Jam es Thom

son for dlscusm on,

crm m

sm , and m

any helpful suggestions

2 D aniel C

allahan, A bol tton Law

, C hoice andM

oiahty (N ew

Y m

k, 1970), p 373 T his book gives a fascinating survey of the

available m foim

atlon on abortion The Jew ish tradition is surveyed

in D avid M

F eldm

an, B uth C

ontlol m Jew

ish Law (N

ew Y

ork, 1968), P

art 5, the C atholic tradition in John T

N oonan, Jr, "A

n A

lm ost A

bsolute V alue in H

m tm

y," in The M olahly ofA

boltw n, ed

John T N oonan, Jr (C

am budge, M

ass, 1970)

3 T

h e

te rm

"d u

e ct" in

th e

m g

u m

e n

ts J re fe

l to is a

te ch

n ica

l one R

oughly, w hat is m

eant by "dnect krlhng" rs either killing as a n e

n d m

itse lf, o

i killin g a

s a m

e a n s to

so m

e e

n d , fo

i e xa

m p le

, th e

e n d o

f sa vin

g so

m e o n e e

lse 's life

S e e n

o te

6 , b

e lo

w , fo

r a n e

xa m

- ple of its use

4 C f E

ncychcal Lettep ofP ope P

m sX

lon C ht tstran M

cu llage, S

t P aul E

ditions (B oston, n d ), p 32 "how

evel m uch w

e m ay pity

...... • u u o ÿ n

C tlltll iU

lU tÿV

t:!l H ie

rs g la

ve ly im

p e lrle

d rfl

perform ance of the duty allotted to her by natm

e, nevm theless w

hat co

u ld

e ve

r b e

a su

fficie n

t re a

so n

fo r e

xcu sin

g m

a n

y w a

y th e

d ire

ct m

urdei of the innocent9 This rs plem sely w

hat w e ale deahng W

ith heie" N

oonan (T ire M

olahty ofA bostw

n, p 43) reads this as fol- lo

w s "W

h a t ca

u se

ca n e

ve r a

va d

to e

xcu se

m a

n y w

a y th

e d

n e

ct

kflhng of the innocent9 For it rs a question of that"

5 The thesrs m (d) is in an m

teiestm g w

ay w eaker than those

in (a), (b), and they role out abom on even in cases m

w hich both

m othm

and child w ill die if the abortion is not perform

ed B y C

on- trast, one w

ho held the vm w

expressed in (d) could consistently say th

a t o

n e n

e e d

n 't p

re fe

r le ttin

g tw

o p

e iso

n s d

ie to

killin g

o n e

6 C f the follow

ing passage fiom P

ros X II, A

ddress to the ltahan C

athohc S ociety of M

ldw rves "The baby in the m

aternal bieast has the right to life Im

m ediately fiom

G od --H

ence there is no m a

no hum an authority, no science, no m

edical eugenic, social, econom nc

o l m

o ra

l 'In d

m a

tlo n

' w h

ich ca

n e

sta b

lish o

l g ia

n t a

va lid

JU n

d lca

l ground for a dnect dehberate dlsposlnon of an innocent hum

an life, that is a thsposm

on w hich looks to its destruction either as an end or

as a m eans to another end pelhaps in itself not illicit --T

he baby, still not born, is a m

an m the sam

e degree and foÿ the sam e leason as the

m othel" (quoted m

N oonan, The M

om hO

, ofA bott!on, p 45)

7 T he need fm

a discussion of this m gum

ent w as biought

hom e to m

e by m em

bers of the S ociety fm

E thical and Legal

P hilosophy, to w

hom thrs papei w

as originally presented 8 F

or a discussion of the dffficultres involved, and a sm vey

of the European experience w ith such law

s, see The G ood Sam

arrtan and the Law

, ed Jam es M

R atchffe (N

ew Y

ork, 1966)

m oiahty of aboition at all R

atheL It is m ade in oppo-

sition to law s against abortion on the ground that the

choice to abort or not IS a m

oial decision that should belong only to the m

other. B ut that specific direction

'of the aigum ent is IrIelevant to our present purposes,

I w ill consider at [latei] w

hen I deal w ith the issues

raised by law s piohIbating abom

ons F oi the m

om ent,

I am concerned solely w

ith the use of tins principle as a putative ground tending to show

the perm lssiblhty

o f a

b o itio

n , w

ith th

e cla

im th

a t b

e ca

u se

it a s th

e w

om an's body that carries the fetus and upon w

hich the fetus depends, she has ceItaIn lights to abort the fetus that no one else m

ay have. W

e m ay begin by rem

arking that it is obviously colrect that, as carrier of the fetus, the m

other has it w

ithin her pow er to choose w

hether or not to abolt the fetus. A

nd, as an autonom ous and responsible agent,

she m ust m

ake tins choice. B ut let us notice that this

in n

o w

a y e

n ta

ils e lth

e l th

a t w

h a te

ve r ch

o ice

sh e

m akes is m

orally right or that no one else has the right to evaluate the decision that she m

akes

B A

R U

C H

B R

O D

Y 363

a disease that he can S U

lV lV

e, but A , if he contracts It,

w all die, and the only w

ay that A can avoid that is by

kllhng B and pushing him

ovelboatd S uiely, A

has no right to do tins. S

o theie m ust be som

e special leason w

hy the m other has, if she does, the fight to abort the

fe tu

s.

T heie IS

, to be suie, an lm poItant diffelence betw

een O

U l lifeboat case and aboitlon, one that leads us to the

heaIt of P rofessoI T

hom son's algum

ent. In the case that w

e envisaged, both A and B

have equal rights to be in the lifeboat, but the m

other's body is heIs and not the fetus's and she has first rights to its use. T

he prim

acy of these lights allow s an aboItIO

n w hether oi

not hei life is threatened P lofessol T

hom son sum

m a-

3 rizes tins aIgum

ent in the follow ing w

ay

B aruch B

rody is Leon Jaw orskl P

rofessor of B m

m edical E

thm s, director of the

C e n te

r fo r M

e d ica

l E th

ics a n d H

e a lth

P o licy a

t th e B

a ylo

r C o lle

g e o

f M e &

cm e ,

A n

d re

w M

e llo

w P

ro fe

sso r o

f H u

m a

n itie

s m th

e D

e p

a rtm

e n

t o f P

h ilo

so p

h y a

t R m

e U

n ive

rsity, a n d d

ire cto

r o f th

e E

th ics P

ro g ra

m a

t M e th

o d ist H

o sp

ita l B

ro d y is a

prohfic w riter m

m any areas of bioethics R

epresentam ,e w

orks include A boÿtw

n a,td the S

anctity of H um

an Life (M IT), D

fe and D eath D

ecm on-M

ahtng (O xford), and

Taking Issue P luÿabsm

aÿzd C asuÿshy zn B

m ethtcs (G

eorgetow n)

Flom A

bol tton and the S anctlO

, of H um

an Life A P

hdosophrcal V

w w

(C am

bridge, M A

M IT

P ress, 1975), pp 26-30, 37-39, and

"F etal H

um anity and the T

heoly of E ssentialism

," in P hdosophy

and S ea, R

obert B aker and F

ledeuck E lhston, eds (B

uffalo, N Y

P rom

etheus B ooks, 1975), pp 348-352 (S

om e palts of these essays

w ere latei m

vrsed by P rofessor B

rody )

body in w ays that she w

ants to and refrain from using

it in w ays that she does not w

ant to. T his nght is pai-

ticulaH y pressed w

here certain uses of her body have deep and lasting effects upon the character of her life, personal, social, and econom

ic T heiefore, it is argued,

a w

o m

a n

sh o

u ld

b e

fre e

e ith

e r to

ca iry h

e i fe

tu s to

term , thereby using hei body to support It, O

l to abolt the fetus, thereby not using her body for that purpose.

In som e contexts in w

hich this m gum

ent is advanced, it is clear that it is not addressed to the issue of the

TH E W

O M

AN 'S R

IG H

T TO H

ER BO

D Y

It is a com m

on claim that a w

om an ought to be in

contiol of w hat happens to hel body to the greatest

extent possible, that she ought to be able to use hel

A t first glance, it w

ould seem that this aigum

ent cannot be used by anyone w

ho supposes, as w e do for

the m om

ent, that there is a point In fetal developm ent

fiom w

hich tim e on the fetus is a hum

an being. A fter

all, people do not have the right to do anything w hat-

soever that m ay be necessary for them

to retain con- tio

l o ve

r th e u

se s o

f th e ir b

o d ie

s In p

a rticu

la r, it

w o

u ld

se e

m w

xo n

g fo

r th e

m to

kill a n

o th

e r h

u m

a n

being In order to do so In a recent article,1 P

rofessor Judith T hom

son has, in

e ffe

ct, a rg

u e d th

a t th

is sim p le

vie w

is m ista

ke n .

H ow

does P rofessor Thom

son defend her claim that

the m other has a right to aboxt the fetus, even if It is

a hum an being, w

hether or not heI life is threatened and w

hether O l not she has consented to the act of

in te

rco u tse

in w

h ich

th e fe

tu s is co

n ce

ive d ? A

t o n e

point,2 discussing just the case in w hich the m

othex's life IS

thleatened, she m akes the follow

ing suggestion:

In [aboltlon], thele are only tw o people involved, one

w hose hfe is threatened and one w

ho threatens it B oth

a re

in n

o ce

n t' th

e o

n e

w h

o ÿs th

re a

te n

e d

is n o

t tin e

a te

n e

d because of any fault, the one w

ho threatens does not thleaten because of any fault For tM

s reason, w e m

ay feel that w e

bystanders cannot m tm

vene B ut the pelson threatened can.

B ut surely this description is equally applicable to the

fn lln

w m

c r ra

ÿ o

' A n

n d

/ÿ m

e a

d rift c

m n

llfo h

n n

t ÿ h

a q

T he M

orality of A bortion

B A

R U

C H

B R

O D

Y

I am algulng only that having a nght to hfe does not

gum antee haw

ng rathe1 a right to be gw en the use of, ol a

rig h t to

b e a

llo w

e d co

n tin

u e d u

se o

f, a n o th

e l p

m so

n 's

b o

d y---e

ve n

if o n

e n

e e

d s it fo

l h fe

Itse lf

O ne part of this claim

is clearly coriect. I have no duty to X

to save X 's life by gw

ing him the use of m

y body (or m

y life savings, or the only hom e I have, and

so on), and X has no right, even to save his life, to any

of those tinngs. T hus, the fetus conceived in the labom

- toly that w

ill peush unless It is Im planted into a w

om an's

body has an fact no right to any w om

an's body But tins portion of the claim

is m elevant to the aboatlon issue,

for in abortion of the fetus that is a hum an being the

m other m

ust kill X to get back the sole use of he1 body, and that is an entilely different m

attel T

h is p

o in

t ca n

a lso

b e

p u

t a s fo

llo w

s w e

m u

st distinguish the taking of X

's life flom the saving of

X 's life, even if w

e assum e that one has a duty not to

do the folm er and to do the latter N

ow that lattea

d u

ty, If it e xists a

t a ll, is m

u ch

w e

a ke

l th a

n th

e first

d u

ty; m a

n y ciicu

m sta

n ce

s m a

y re lie

ve u

s fio m

th e

la tte

r d u

ty th a

t w ill n

o t re

h e

ve u

s fro m

th e

fo rm

e r

o n e T

h u s, I a

m ce

rta in

ly re lie

ve d fro

m m

y d u ty to

save X 's life by the fact that fulfilling It m

eans the loss of m

y life savings. It m ay be noble for m

e to save X 's

life at the cost of everything I have, but I celtaInly h

a ve

n o

d u

ty to d

o th

a t A

n d

th e

sa m

e o

b se

rva tio

n m

ay be m ade about cases in w

hich I can save X 's life

by giving him the use of m

y body fol an extended period of tim

e H ow

evel, I am not relieved of m

y duty not to take X

's life by the fact that fulfilling It m eans

the loss of evelything I have and not even by the fact th

a t flllfillln

o it m

o n n q th

e lo

rr n f m

y life

364 R E

P R

O D

U C

T IO

N

A t one point m

hel papel, P rofessol T

hom son does

consldel this objection S he has plevlously am

agm ed

th e fo

llo w

in g ca

se . a

fa m

o u s vio

lin ist, w

h o is d

yin g

flo m

a M

d n e y a

ilm e n t, h

a s b

e e n , w

ith o u t yo

u r co

n -

sent, plugged Into you for a period of tim e so that his

body can use your kidneys:

S om

e people ale lathm stnctm

about the right to life In then vm

w , it does not include the right to be given anythang,

but am ounts to, and only to, the right not to be killed by

anybody B ut hem

a related difficulty auses If evm ybody as

to m fiam

flom kllhng that vaohnast, then evm

ybody m ust

lefaam flora doing a gJeat m

any & ffelent soÿts of things

everybody m ust refiam

flom unplugging you fiom

ham B

ut does he have a right against everybody that they shall lefiam from

unplugging you fiom him

9 To leflam from

doing this is to

a llo

w h

im to

co n tin

u e to

u se

yo re

kid n e ys . cm

ta m

ly the w

ohm st has no right against you that you shall allow

ham to continue to use yore M

dneys

A p p lyin

g th

is a ig

u m

e n t to

th e ca

se o

f a b o Itio

n , w

e can see that P

rofessor T hom

son's atgum ent w

ould iun as follow

s:

a A ssum

e that the fetus's iight to hfe Includes the right not to be M

lled by the w om

an carrying him .

b. B ut to lefrain flom

kllhng the fetus IS to allow

him the continued use of the w

om an's body.

c S o

o u

I filS t a

ssu m

p tio

n e

n ta

ils th a

t th e

fe tu

s's right to life Includes the right to the continued use of the w

om an's body

d. B ut w

e all grant that the fetus does not have the right to the continued use of the w

om an's body.

e . T

h e

re fo

ie , th

e fe

tu s's n

g h

t to life

ca n

n o

t in -

clude the light not to be killed by the w om

an in

q u

e s tio

n .

A nd it is also now

cleal w hat IS

w Iong w

ith this argu- m

ent W hen w

e glanted that the fetus has no right to th

e co

n tin

u e d u

se o

f th e w

o m

a n 's b

o d y, a

ll th a t w

e m

e a n t w

a s th

a t h

e d

o e s n

o t h

a ve

th is rig

h t m

e le

ly because the continued use saves his life. B

ut, of couise, thele m

ay be other reasons w hy he has this right. O

ne w

ould be that the only w ay to take the use of the

w om

an's body aw ay flom

the fetus is by lolling him ,

and that as som ething that neathei she nor w

e have the right to do. S

o, I subm it, the w

ay in w hich A

ssum ption

d is true is n'relevant, and cannot be used by P rofessoi

T hom

son, for A ssum

ption d is true only in cases w hele

the saving of the life of the fetus is at stake and not in cases w

here the taking of his life iÿ at ÿtnke

I conclude therefore that P rofessoi T

hom son has "!'ÿ

not established the truth of hei claim s about aboitm

n, pum

arily because she has not sufficiently attended to the distraction betw

een O U

l duty to save X 's life and

our duty not to take it. O nce one attends to that dis.

tln ctio

n , it w

o u ld

se e m

th a t th

e m

o th

e l, in

o Id

e r to

regain control ovel her body, has no nght to abort the fe

tu s fio

m th

e p

o in

t a t w

h ich

it b e co

m e s a

h u m

a n

being.

It m ay also be useful to say a few

w olds about the

la Ig

e i a

n d

le ss Iig

o io

u s co

n te

xt o f th

e a

rg u

m e

n t

th a t th

e w

o m

a n h

a s a

rig h t to

h e i o

w n b

o d y. It is

surely true that one w ay in w

hich w om

en have been opplessed is by their being denied authority over th

e ir o

w n b

o d ie

s B u t it se

e m

s to m

e th

a t, a

s th e

stIuggle is cairIed on for m eaningful am

elioration of such opplession, it ought not to be canled so far that It violates the steady responsiblhties all people have to one anothel. P

atents m ay not deseit theii children,

one class m ay not oppress another, one race O

l nation m

a y n

o t e

xp lo

it a n o th

e i F

o r p

a re

n ts, p

o w

e rfu

l g

Io u

p s in

so cie

ty, la ce

s o r n

a tio

n s in

a sce

n d

a n

cy, th

e le

a re

p e n a ltie

s fo i re

fia in

ln g fro

m th

e se

w io

n g

actions, but those penalties can in no w ay be taken

as the justification foI such w iong actions. S

im ilarly,

if the fetus is a hum an being, the penalty of cariylng

it ca n n o t, I b

e lie

ve , b

e u

se d a

s th e ju

stifica tio

n fo

r d

e stlo

yin g

it.

TH E M

O D

EL PEN AL C

O D

E C ASES

A ll of the atgum

ents that w e have looked at so fat" ate

attem pts to show

that there IS som ething special about

aboItIon that justifies its being tleated differently from othei cases of the taking of hum

an life. W e shall now

co n

sid e

r cla im

s th a

t a te

co n

fin e

d to

ce ita

in sp

e cia

l ca

se s o

f a b

o ltIo

n th

e ca

se in

w h

ich th

e m

o th

e l h

a s

been laped, the case In w hich beanng the child w

ould be harm

ful to her health, and the case in w hich having

the child m ay cause a problem

for the rest of hei fam

ily (the lattel case is a paiticular case of the soci- etal argum

ent). In addiessing these Issues, w e shall

see w hether there is any point to the perm

issiblhty of aboltions in som

e of the cases coveled by the M odel

P enal C

ode4 ploposals. W

hen the expectant m other has conceived after

being taped, theie ate tw o diffelent soIts of consider-

ations that m ight suppolt the claim

that she has the nght to take the life of the fetus. They are the follow

-

flom the act of iape and the physical and/or

psychological afteleffects of that act. It w ould be pat-

ticularly unjust, the atgum ent Iuns, foi heI to have to

live thiough an unw anted plegnancy ow

ing to that act of iape. T

heiefole, even if w e are at a stage at w

hich the fetus is a hum

an being, the m otheI has the right

to aboIt it; (B ) the fetus In question has no light to be

in that w om

an. It w as put there as a lesult of an act

of agglessIon upon hel by the iaplst, and its contin- ued piesence is an act of aggression against the m

othel. S

he has a light to repel that aggression by aboitlng the fetus.

T he filS

t argum ent is veIy com

pelling. W e can all

agiee that a teiuble injustice has been com m

itted on the w

om an w

ho is 1aped T he questm

n that w e have

to co

n sid

e l, h

o w

e ve

r, IS w

h e th

e i it fo

llo w

s th a t it is

m o

ra lly p

e im

lssIb le

fo r h

e r to

a b

o rt th

e fe

tu s W

e m

u st m

a ke

th a

t co n

sld e

la tio

n le

fle ctln

g th

a t, h

o w

- eveI unJust the act of iape, it w

as not the fetus w ho

co m

m itte

d o

r co m

m issio

n e d it. T

h e in

ju stice

o f th

e act, then, should in no w

ay im pinge upon the rights

o f th

e fe

tu s, fo

l it is in n o ce

n t W

h a t re

m a in

s is th e

initial m lsfoltune of the m

otheI (and the injustice of h e I h

a vin

g to

p a ss th

Io u g h th

e p

ie g n a n cy, a

n d , fu

i- th

e r, to

a ssu

m e

re sp

o n

sib ility o

f a t le

a st g

ivin g

th e

ch ild

o vm

fo i a

d o p tio

n o

r a ssu

m in

g th

e b

u id

e n o

f its ca

Ie ). H

o w

e ve

i u n fo

ltu n a te

th a t circu

m sta

n ce

, h

o w

e ve

l u n

ju st, th

e m

isfo rtu

n e

a n

d th

e in

ju stice

are not sufficient cause to justify the taking of the life

o f a

n in

n o

ce n

t h u

m a

n b

e in

g a

s a m

e a

n s o

f m

itig a tio

n It is at this point that A

rgum ent B

com es in, for Its

w hole point IS

that the fetus, by its m ere plesence In

the m other, IS

com m

itting an act of aggression against h

e i, o

n e

o ve

r a n

d a

b o

ve th

e o

n e

co m

m itte

d b

y th e

iapist, and one that the m other has anght to iepel by

abortion. B ut. . (1) the fetus is cm

tainly innocent (in the sense of not Iesponsible) for any act of aggression a

g a

in st th

e m

o th

e r a

n d

. (2 ) th

e m

e le

p Ie

se n

ce o

f the fetus in the m

otheI, no m atter how

unfoltunate for her, does not constitute an act of aggIession by the fetus against the m

other. A igum

ent B falls then at just

that point at w hich A

rgum ent A

needs its suppol t, and w

e can therefore conclude that the fact that piegnancy IS

the result of iape does not give the m othei the light

to abort the fetus W

e tu

ln n

e xt to

th e ca

se in

w h ich

th e co

n tin

u e d

existence of the fetus w ould threaten the m

ental and/or physical health but not necessalily the life of the m

othei. A gain, . . the fact that the fetus's continued

• . .I i p ÿ

.,

B A

R U

C H

B R

O D

Y 365

n o

t ju stify h

e r a

b o

ltm g

it.ÿ It w o

u ld

se e

m to

b e

tlu e

, a foition, that the fact that the fetus's continued exis- te

n ce

p o

se s a

th re

a t to

th e

m e

n ta

l a n

d /o

l p h

ysica l

health of the m othei does not justify hei abolting It

eithei W

e com e finally to those cases in w

hich the con- tlnuation of the piegnancy w

ould cause serious plob- le

m s fo

i th e le

st o f th

e fa

m ily. T

h e le

a le

a va

lie ty o

f cases that w

e have to considel heIe togethel. P eihaps

the health of the m othei w

ill be affected in such a w

a y th

a t sh

e ca

n n o t fu

n ctio

n e

ffe ctive

ly a s a

w ife

and m other during, or even afteI, the plegnancy O

1 p

e lh

a p

s th e

e xp

e n

se s ln

cu rie

d a

s a re

su lt o

f th e

pIegnancy w ould be utteIly beyond the financial

re so

u ice

s o f th

e fa

m ily T

h e Im

p o rta

n t p

o in

t is th a t

th e co

n tin

u a tio

n o

f th e p

re g n a n cy ra

ise s a

se u o u s

p ro

b le

m fo

i o th

e i in

n o ce

n t p

e o p le

in vo

lve d b

e sid

e s

the m other and the fetus, and It m

ay be rogued that the m

other has the nght to abort the fetus to avoid that problem

. B

y now , the difficulties w

ith this aigum ent should

be appaIent W e have seen earlier that the m

ere fact that the continued existence of the fetus threatens to haim

the m othei does not, by itself, justify the aboIt-

Ing of the fetus. W hy should anything be changed by

the fact that the threatened harm w

ill acciue to the other m

em bels of the fam

ily and not to the m other9

O f C

O U

lS e, it w

ould be different if the fetus w ere com

- m

itting an act of aggression against the other m em

- b

e ls o

f th e

fa m

ily. B u

t, o n

ce m

o ie

, th is is ce

rta in

ly not the case

*E dttol's note P

rofessol B tody piow

ded a lengthy argum ent to

this effect m a chaptm

not hm e excm

pted H is sum

m m

y of that a rg

u m

e n t is

a s fo

llo w

s "Is

it p e rm

is s ib

le , a

s a

n a

c t o

t k illin

g a

pulsuei, to abm t the fetus in m

dm to save the m

othel9 T he first

thing that w e should note is that P

ope P ius's objection to abort-

ing the fetus as a pelm isslble act of kllhng a puIsuei is m

istaken H

is objection is that the fetus show s no know

ledge oi m tentm

n In his attem

pt to take the hfe of the m other, that the fetus ÿs, m

a w ord, innocent B

ut that only m eans that the con&

non of guilt is

n o

t s a

tis fie

d , a

n d

w e

h a

v e

s e

e n

th a

t ÿ ts

s a

tls fa

c tm

n is

n o

t n e ce

ssa ly"

"Is, th e

n , th

e a

b o

itin g

o f th

e fe

tu s, w

h e

n n

e ce

ssa ly to

sa ve

th e

hfe of the m othei, a peim

issible act of kflhng a pulsum 9 It is tree

that m such cases the fetus is a dangel to the m

othei B ut tt is also

cleal that the condm on of attem

pt is not satisfied The fetus has nm -

th in

th e b

e lie

fs n m

th e iu

te n tio

n to

w h ich

w e h

a ve

ie fm

ie d

F u

rth e

tm o

le , th

e m

ÿs o n

th e

p a

ir o f th

e fe

tu s n

o a

ctm ,1

th a

t th re

a t-

e n

s th e

life o

f th e

m o

th e

i S o

n o

t e ve

n th

e co

n d

itio n

o f a

ctio n

is sa t-

lsfied It seem s to follow

, theÿefole, that abom ug the fetus could not

1 ÿ . o

, 1 1

366 R E

P R

O D

U C

T IO

N

W e conclude, thelefole, that none of these special

circum stances justifies an abortion fiom

that point at w

hich the fetus is a hum an being

FE TA

L H U

M A

N ITY

A N

D B

R A

IN FU

N C

TIO N

T he question w

hich w e m

ust now consider is the ques-

tion of fetal hum anity. S

om e have argued that the fetus

is a h

u m

a n

b e

m g

w ith

a rig

h t to

life (o

r, fo r co

n ve

- nience, just a hum

an being) from the m

om ent of con-

ception O thers have argued that the fetus only becom

es a hum

an being at the m om

ent of birth M any positions

in betw een these tw

o extlem es have also been sug-

gested. H ow

ale w e to decide w

hm h is conect9

T he analysis w

hich w e w

ill piopose here rests upon certain m

etaphysical assum ptions w

hich I have defended elsew

here. T hese assum

ptions are: (a) the question IS w

hen has the fetus acquired all the properties essen- U

al (necessaly) fol being a hum an being, fol w

hen it has, it is a hum

an being; (b) these plopertles ale such that the loss of any one of them

m eans that the hum

an being in question has gone out of existence and not m

erely stopped being a hum an being; (c) hum

an beings go out of existence w

hen they die It follow s

fro m

th e se

a ssu

m p tio

n s th

a t th

e fe

tu s b

e co

m e s a

hum an being w

hen it acquiles all those chalactenstics w

hich ai'e such that the loss of any one of them w

ould result in the fetus's being dead. W

e m ust, therefore,

turn to the analysis of death.

W e w

ill fiist considel the question of w hat prop-

e rtie

s a re

e sse

n tia

l to b

e in

g h

u m

a n if w

e su

p p o se

th a

t d e

a th

a n

d th

e p

a ssin

g o

u t o

f e xiste

n ce

o ccu

r o n ly If th

e re

h a s b

e e n a

n lrre

p a la

b le

ce ssa

tio n o

f blain function (keeping In m

ind that that condition itself, as w

e have noted, as a m atter of m

edical judg- m

ent) W e shall then consider the sam

e question on the supposition that [P

aul] R am

sey's m ore com

pli- cated theory of death (the m

odified traditional view )

is co n

'e ct.

A ccording to w

hat is called the blain-death theory, as long as thele has not been an inepm

able cessation of blain function the person In question continues to exist, no m

atter w hat else has happened to him

. If so, It se

e m

s to fo

llo w

th a

t th e

ie is o

n ly o

n e

p ro

p e

rty--

that is essential to hum anity, nam

ely, the possession ' of a brain that has not suffeied an lnepaiable cessa, tio

n o

f fu n ctio

n .

S e ve

ra l co

n se

q u e n ce

s fo llo

w Im

m e d ia

te ly flo

ra th

is co n

clu sio

n . W

e ca

n se

e th

a t a

va iIe

ty o f o

fte n

advanced claim s about the essence of hum

anity m e

false. For exam ple, the claim

that m ovem

ent, or peihaps just the ability to m

ove, is essential foi being hum an is

false. A hum

an being w ho has stopped m

oving, and e ve

n o

n e w

h o h

a s lo

st th e a

b ility to

m o ve

, h a s n

o t

therefole stopped existing. B eing able to m

ove, and a forhori m

oving, are not essential propem es of hum

an beings and therefore are not essential to being hum

an. S

im ilarly, the claim

that being perceivable by other h u m

a n b

e in

g s is e

sse n tia

l fo r b

e in

g h

u m

a n is a

lso false. A

hum an being w

ho has stopped being peIceiv- able by other hum

ans (fol exam ple, som

eone isolated o n th

e o

th e r sid

e o

f th e m

o o n , o

u t o

f re a ch

e ve

n o

f radio com

m unication) has not stopped existing B

eing perceivable by other hum

an beings is not an essential property of hum

an beings and is not essential to being hum

an. A nd the sam

e point can be m ade about the

claim s that viability is essential for being hum

an, that independent existence is essential fol being hum

an, and that actual interaction w

ath otheI hum an beings is

essential for being hum an. T

he loss of any of these plopelties w

ould not m ean that the hum

an being in question had gone out of existence, so none of them can be essential to that hum

an being and none of them can be essential for being hum

an Let us now

look at the follow ing argum

ent: (1) A functioning brain (or at least, a brain that, if not func- tioning, is susceptible of function) IS

a property that every hum

an being m ust have because it is essential

for being hum an. (2) B

y the tim e an entity acquiies

that property, it has all the othel propem es that ale

essential for being hum an. T

helefole, w hen the fetus

acquires that property it becom es a hum

an being. It is clear that the property in question IS

, accoldlng to the brain-death theory, one that is had essenU

ally by all hum

an beings. T he question that w

e have to consider is w

hethei the second piem lse is true. It m

ight appear that its truth does follow

from the brain-death theoIy.

A fter all, w

e did see that the theory entails that only one pxoperty (together w

ith those entailed by it) is essential fox being hum

an. N evertheless, lather than

relying solely on m y earlier argum

ent, I shall adopt an alternative apploach to strengthen the conviction that this second pIem

lse is true: I shall note the im poatant

w ays in w

hich the fetus lesem bles and differs from

an

t'unctioning brain (about the end of the sixth w eek of

developm ent). It shall then be evident, in light of our

theory of essentialism , that none of these differences

involves the lack of som e propeity m

the fetus that is essential foi its being hum

an. S

tru ctm

a lly, th

e le

a le

fe w

fe a tu

ie s o

f th e h

u m

a n

being that are not fully piesent by the end of the sixth w

eek. N ot only are the fam

ihar exteinal features and all the internal organs present, but the contours of the body m

e nicely lounded. M ote im

portant, the body is functioning N

ot only is the brain functioning, but the heait is beating sturdily (the fetus by this tim

e has its ow

n com pletely developed vascular system

), the stom -

a ch

is p io

d u cin

g d

ig e stive

ju ice

s, th e live

r is m a n u -

fa ctu

rin g b

lo o d ce

lls, th e kid

n e y is e

xtra ctin

g u

ric acid from

the blood, and the nerves and m uscles ale

opeiatlng in concert, so that reflex aeacU ons can begin.

W hat ale the properties that a fetus acqulleS

after the sixth w

eek of its developm ent9 C

ertain stluctures do appear later. These include the fingernails (w

hich appear in the third m

onth), the com pleted vocal chords

(w hich also appear then), taste buds and salivary

glands (again, m the thlld m

onth), and hair and eye- lashes (in the fifth m

onth). In addition, ceitaIn func- tions begin later than the sixth w

eek The fetus begins to unnate (in the thaId m

onth), to m ove spontaneously

(m the thn'd m

onth), to respond to external stim uli (at

least in the fifth m onth), and to bleathe (in the sixth

m onth) M

oreovel, there is a constant grow th in size.

A nd finally, at the hm

e of birth the fetus ceases to ieceive ItS

oxygen and food through the placenta and starts receavIng them

through the m outh and nose

I w ill not exam

ine each of these piopelties (struc- tures and functions) to show

that they ale not essential foi being hum

an. T he procedure w

ould be essentially the one used pievlously to show

that various essen- tlahst claim

s are in error. W e m

ight, therefore, con- clude, on the supposition that the blain-death theory is colT

ect, that the fetus becom es a hum

an being about the end of the sixth w

eek aftel its developm ent.

T hele IS

, how ever, one com

plication that should be noted here. T

here ale, after all, progressive stages In the physical developm

ent and in the functioning of the brain. F

or exam ple, the fetal brain (and nervous

system ) does not develop sufficiently to support spon-

ta n e o u s m

o tio

n u

n til so

m e tim

e in

th e th

ird m

o n th

after conception. T here as, of couise, no doubt that

that stage of developm ent is sufficient for the fetus to

be hum an. N

o one w ould be likely to m

aintain that a sp

o n

ta n

e o

u sly m

o vin

g h

u m

a n

b e

in g

h a

s d ie

d ; a

n d

sim ilarly, a spontaneously m

oving fetus w ould seem

B A

N U

L ÿ ÿ

K ÿ r .... 3

ÿ 7 .....

to have becom e hum

an O ne m

ight, how eveI, w

ant to claim

that the fetus does not becom e a hum

an being until the point of spontaneous m

ovem ent S

o then, on the supposition that the brain-death theory of death is correct, one ought to conclude that the fetus becom

es a hum

an being at som e tim

e betw een the sixth and

tw elfth w

eek after its concepU on

B u

t w h

a t if w

e re

je ct th

e b

ra in

-d e

a th

th e

o Iy, a

n d

replace at w ith its equally plausible contendea, R

am sey's

theory of death? A ccording to that theoay--w

hlch w e

ca n ca

ll th e b

ra in

, h e a it, a

n d lu

n g th

e o iy o

f d e a th

-- the hum

an being does not die, does not go out of exis- tence, until such tim

e as the brain, healt, and lungs have m

epaIably ceased functm ning naturally W

hat are the essential features of being hum

an according to this theoay9

A ctually, the adoption of R

am sey's theory requires

no m ajor m

odifications A ccording to that theory, w

hat IS

essential to being hum an, w

hat each hum an being

m ust retain if he is to continue to exist, is the posses-

sion of a functioning (actually or potentially) heait, lu

n g

, o r b

ra in

It is o n

ly w h

e n

a h

u m

a n

b e

in g

p o

s- sesses none of these that he dies and goes out of exis- tence, and the fetus com

es into hum anity, so to speak,

w hen he acqunes one of these.

O n R

am sey's theory, the argum

ent w ould now

run as follow

s: (1) The property of having a functioning b

ra in

, h e

a it, o

r lu n

g s (o

r a t le

a st o

rg a

n s o

f th e

kin d

that, if not functioning, are susceptible of function) is one that every hum

an being m ust have because at is

essenU al fol being hum

an. (2) B y the tim

e that an entity acquues that property it has all the other prop_ erties that are essenU

al for being hum an T

herefole, w

h e

n th

e fe

tu s a

cq u

u e

s th a

t p ro

p e

rty it b e

co m

e s a

hum an being. T

heie rem ains, once m

ore, the problem o f th

e se

co n d p

re m

ise . S

in ce

th e fe

ta l h

e a rt sta

rts operating lathea early, it is not clear that the second plem

xse is colrect. M any system

s are not yet opelat- ing, and m

any stiuctures are not yet present. S till, fol-

low ing our theoly of essentialism

, w e should conclude

that the fetus becom es a hum

an being w hen it acquixes

a functioning heart (the first of the organs to function in the fetus).

T hele as, how

ever, a further com phcatlon hele, and

It is analogous to the one encounteaed if w e adopt the

brain-death theoIy W hen m

ay w e paoperly say that

the fetal heart begins to functlon9 A t tw

o w eeks, w

hen occasional contractions of the prim

itive fetal heart are present? In the fourth to fifth w

eek, w hen the heart,

although incom plete, is beating legularly and pum

p- ing blood cells thiough a closed vasculal system

, and w

hen the tracings obtained by an E C

G exhibit the

cla ssica

l e le

m e

n ts o

f a n

a d

u lt txa

cln g

9 0

i a fte

r th e

end of the seventh w eek, w

hen the fetal heait as func- tionally com

plete and "norm al"9

W e have not reached a plecise conclusion in O

U l

stu d y o

f th e q

u e stio

n o

f w h e n th

e fe

tu s b

e co

m e s a

hum an being. W

e do know that it does so som

e tim e

betw een the end of the second w

eek and the end of the third m

onth B ut it sulely is not a hum

an being at the m

om ent of conception and it surely is one by the

end of the thild m onth Though w

e have not com e to

a final answ er to our question, w

e have nariow ed the

lange of acceptable answ els consldelably.

tm su

m m

a ryj w

e h

a ve

a lg

u e o m

a t th

e Ictu

s com

es a hum an benlg w

ith a light to hfe som e tim

e betw

een the second and tw elfth w

eek ariel concep. tion. W

e have also aigued that aboitIons ale m orally

Im pelm

lssible aflel that point except in lathel unU S

ual circum

stances W hat is crucial to note is that neither

of these aIgum ents appeal to any theological considÿ

eiations W e conclude, theiefore, that there is a hum

an- rights basis fol m

oral opposition to aboltions.

N O

TES 1 J T

hom son, "A

D efense of A

bom on," P

lulosophy and Pubhc Affairs, Vol 1 (1971), pp 47-66

2 Ibld, p 53 3 Ibld, p 56 4 O

n the M odel P

enal C ode plovism

ns, see A m

erican Law Insntute, M

odel P enal C

ode T entanve D

laft N o 9 (1959)

g e n e tic

lm in

a n ity

, i.e ., lm

m a iiity

a s ÿ

b y y

N o

o n

a n

, w h

ich is th

e b

a sis fo

r m e

m b

e ish

ip in

th is

com m

unity I w ill argue that a fetus, w

hatevei its stage of developm

ent, satisfies none of the basic critena of peisonhood, and is not even enough like a peison to be accoided even som

e of the sam e rights on the basis

of this resem blance N

oi, as w e w

ill see, IS a fetus's

potential pelsonhood a thleat to the m orality of aboi-

tio n

, sin ce

, w h

a te

ve i th

e rig

h ts o

f p o

te n

tia l p

e o

p le

m ay be, they ale invariably ovem

dden in any conflict w

ith the m olal rights of actual people.

M A

R Y

A N

N E

W A

R R

E N

309

M A

R Y

A N

N E

W A

R R

E N

O n

th e

M o

ra l a

n d

L e

g a

l S ta

tu s o

f A b

o rtio

n

From The M

om st 57, no 1 (Janum

y 1973), pp 43-61 C opyught

© 1973, The M

onist A n hltet national Q

ual tel ly Jottt hal ofG enet al

P htlosophm

al hÿqutl3; P m

u, Ilhnm s, U

S A

61354 R eplm

ted by p

e lm

lS slo

n

In S

e ctio

n I, w

e w

ill co n sid

e i w

h e th

e I o

i n o t It is

possible to establish that abortion is m olally perm

is- sible even on the assum

ption that a fetus is an entity w

ith a full-fledged right to hfe. I w ill argue that in fact

this cannot be established, at least not w ith the con-

clu slve

n e ss w

h ich

is e sse

n tia

l to o

u i h

o p e s o

f co n -

vlncing those w ho are skeptical about the m

olahty of abortion, and that w

e therefore cannot avoid dealing w

ith the question of w hether or not a fetus ieally does

have the sam e nght to life as a (m

ole fully developed) hum

an being In S

ection II, I w ill plopose an answ

ei to this ques- tio

n , n

a m

e ly, th

a t a

fe tu

s ca n

n o

t b e

co n

sld e

le d

a m

e m

b e

i o f th

e m

o ra

l co m

m u

n ity, th

e se

t o f b

e in

g s

w ith full and equal m

oral ughts, for the sim ple reason

that it is not a pelson, and that it is personhood, and

I w ill argue that, w

hile It IS not possible to produce a

satlsfactoIy defense of a w om

an's nght to obtain an aboltIO

n w ithout show

ing that a fetus is not a hum an

being, in the m orally relevant sense of that term

, w e

ought not to conclude that the difficulties involved in determ

ining w hethei or not a fetus is hum

an m ake it

im possible to ploduce any satisfactory solution to the

pioblem of the m

oial status of abortion. F ol it is pos-

sible to show that, on the basis of Intuitions w

hich w e

m ay expect even the opponents of aboItion to share,

a fetus IS not a person, and hence not the soit of entity

to w hich it is plopei to ascribe full m

olal nghts

I W

e tu

in n

o w

to P

ro fe

sso r [Ju

d ith

] T h

o m

so n

's ca se

fol the claim that even if a fetus has full m

oial rights, a b o rtio

n is still m

o ia

lly p e lm

isslb le

, a t le

a st so

m e -

tim es, and fol som

e reasons other than to save the w

om an's hfe 1 H

er algum ent is based upon a clevei,

b u

t I th in

k fa u

lty, a n

a lo

g y. S

h e

a sks u

s to p

lC tU

le ouiselves w

aking up one day, In bed w ith a fam

ous violinist Im

agine that you have been kidnapped, and yo

u i b

lo o d stre

a m

h o o ke

d u

p to

th a t o

f th e vio

lin ist,

w ho happens to have an ailm

ent w hich w

ill ceitalnly kill him

unless he is pelm itted to share your kidneys

fo r a

p e

rio d

o f n

in e

m o

n th

s. N o

o n

e e

lse ca

n sa

ve h

im , sin

ce yo

u a

lo n

e h

a ve

th e

ilg h

t typ e

o f b

lo o

d H

e w

ill b e

u n co

n scio

u s a

ll th a

t tim e

, a n

d yo

u w

ill h

a ve

to sta

y in b

e d

w ith

h im

, b u

t a fte

l th e

n in

e m

o n

th s a

re o

ve r h

e m

a y b

e u

n p

lu g

g e

d , co

m p

le te

ly culed, that is, plovided that you have coopelated.

N ow

then, she continues, w hat aie your obligations

In this S ltU

atlon9 T he antiaboltlonist, if he 1s consis-

tent, w ill have to say that you ale obligated to stay in

bed w ith the vlohnlst fox all people have anght to

life, and violinists are people, and therefore it w ould

b e

m u

rd e

r fo r yo

u to

d isco

n n

e ct yo

u rse

lf fro m

h im

and let him die (p 49). B

ut this IS O

U tlageous, and so

there m ust be som

ething w rong w

ith the sam e argu-

m ent w

hen it is apphed to abortion It w ould ceitainly

be com m

endable of you to agiee to save the violinist, but it IS

absuId to suggest that youl refusal to do so w

o u

ld b

e m

u id

e r H

is l'lg h

t to life

d o

e s n

o t o

b lig

a te

you to do w hatevel is required to keep him

alive; no1 does it justify anyone else in folcIng you to do so. A la

w w

h ich

ie q

u lre

d yo

u to

sta y in

b e

d w

ith th

e V

lO -

h n

lst w o

u ld

cle a

ily b e

a n

u n

ju st la

w , sin

ce It is n

o p

lo p

e r fu

n ctio

n o

f th e

la w

to fo

rce u

n w

illin g

p e

o p

le to m

ake huge saciIfices foi the sake of otheI people tow

ard w hom

they have no such pllO l obligation

T hom

son concludes that, if this analogy IS an apt

o n

e , th

e n

w e

ca n

g ra

n t th

e a

n tia

b o

rtlo n

lst h is cla

im

M ary kam

e W arren w

as professor of philosophy at S an F

rancisco S tate U

niversity. S

he has w ritten on m

any topics concerning abortion and felnxnism R

epresentative pubhcatlons Include "T

he A boi tion S

truggle in A m

erica," B zoethtcs, M

oral S tatus

O bligations to P

ersons and O theÿ Lÿvm

g Things (O xford), G

endeÿc, de The Im phcatÿons of

S ex S

elecO on (R

ow m

an & Littlefield), and The N

atm e of W

om an A

n E vcyclopedm

& G

uM e to the L, tem

tm e (Edgepress)

that a fetus is a hum an being, and still hold that it is

at least som etim

es the case that a pregnant w om

an has the right to refuse to be a G

ood S alnautan tow

aids the fe

tu s, 1

e ., to

o b ta

in a

n a

b o itIo

n F

o r th

e ie

is a g

le a t

g a

p b

e tw

e e

n th

e cla

im th

a t x h

a s a

u g

h t to

life , a

n d

the claim that 3' IS

obligated to do w hatever is neces-

sa ry to

ke e

p a

a live

, le t a

lo n

e th

a t h

e o

u g

h t to

b e

fo xce

d to

d o

so . It is y's d

u ty to

ke e

p x a

live o

n ly if

he has som ehow

contiacted a specm l obligation to do

so , a

n d

a w

o m

a n

w h

o is u

n w

llh n

g ly p

re g

n a

n t, e

g .,

w ho w

as iaped, has done nothing w hich obligates her

to m ake the enorm

ous sacrifice w hich is necessaIy to

pleseive the conceptus T

h is a

lg u m

e n t is in

itia lly q

u ite

p la

u sib

le , a

n d In

the extrem e case of piegnancy due to iape it is piob-

ably conclusive. D ifficulties ause, how

evel, w hen w

e tiy to specify m

ore exactly the lange of cases in w hich

abortion is clearly justifiable even on the assum ption

that the fetus is hum an. P

iofessol T hom

son considers it a vntue of her argum

ent that it does not enable us to

co n clu

d e th

a t a

b o ltIO

n is a

lw a ys p

e im

lsslb le

. It w

o u ld

, sh e sa

ys, b e "in

d e ce

n t" fo

i a w

o m

a n in

h e l

se ve

n th

m o

n th

to o

b ta

in a

n a

b o

rtio n

ju st to

a vo

id h a vin

g to

p o stp

o n e a

trip to

E u io

p e . O

n th

e o

th e i

hand, her argum ent enables us to see that %

sick and despelately fi'lghtened schoolgirl plegnant due to rape m

ay of corn se choose abortion, and that any law w

hich ru

le s th

is o u t is a

n in

sa n e la

w " (p

6 5 ) S

o fa

l, so good; but w

hat ale w e to say about the w

om an w

ho becom

es piegnant not thiough rape but as a result of hel ow

n calelessness, or because of contl aceptlve fail- u re

, o r w

h o g

e ts p

re g n a n t in

te n tio

n a lly a

n d th

e n

changes hei m ind about w

anting a child9 W ith lespect

to such cases, the violinist analogy is of m uch less use

to th

e d

e fe

n d e r o

f th e w

o m

a n 's u

g h t to

o b ta

in a

n aboltlO

n Indeed, the choice of a pregnancy due to tape, as

an exam ple of a case in w

hich abortion IS perm

issible e ve

n if a

fe tu

s is co n sid

e le

d a

h u m

a n b

e in

g , IS

e x-

trem ely significant, for it as only in the case of preg-

n a n cy d

u e to

1 a p e th

a t th

e w

o m

a n 's situ

a tio

n a

s adequately analogous to the vlohm

st case for our intu- itio

n s a

b o

u t th

e la

tte l to

tra n

sfe i co

n vin

cin g

ly T h

e crucial dlffelence betw

een a pregnancy due to rape and the norm

al case of an unw anted plegnancy is that

in the noim al case w

e cannot claim that the w

om an is

in no w ay lesponsible for hel pledlcam

ent, she could have iem

ained chaste, O l taken hei pills m

ole faith- fully, or abstained on dangerous days, and so on. If,

o n

th e

o th

e i h

a n

d , yo

u a

Ie kid

n a

p p

e d

b y stra

n g

e rs,

and hooked up to a stlange violinist, then you are free of any shied of lesponsiblhty fol the situation, on the basis of w

hich at w ould be argued that you are obli-

gated to keep the vlohnlst alive. O nly w

hen her pleg- nancy is due to lape is a w

om an cleally just as non-

Iesponslble.2 C

onsequently, thele IS room

fol the antiaboltlO m

S t

to a

rg u e th

a t in

th e n

o rm

a l ca

se o

f u n w

a n te

d p

re g -

n a n cy a

w o m

a n h

a s, b

y h e i o

w n a

ctio n s, a

ssu m

e d

responsibility for the fetus. F ol if x behaves in a w

ay w

h ich

h e

co u

ld h

a ve

a vo

id e

d , a

n d

w h

ich h

e kn

o w

s in

vo lve

s, le t u

s sa y, a

1 p

e lce

n t ch

a n

ce o

f b rin

g in

g into existence a hum

an being, w ith a right to life, and

does so know ing that ff this should happen then that

hum an being w

ill pellsh unless x does certain things to

ke e p h

im a

live , th

e n it is b

y n o m

e a n s cle

a r th

a t

w h e n it d

o e s h

a p p e n a

IS fle

e o

f a n y o

b lig

a tio

n to

w hat he knew

in advance w ould be lequired to keep

that hum an being alive

The plausibility of such an argum ent IS

enough to show

that the T hom

son analogy can provide a clear and persuasive defense of a w

om an's right to obtain

an abortion only w ith respect to those cases in w

hich th

e w

o m

a n

is in n

o w

a y re

sp o

n sib

le fo

l h e

l p re

g -

nancy, e g., w hele it is due to rape In all othel cases,

w e w

ould alm ost celtam

ly conclude that it w as nec-

essaiy to look cm efully at the particular cflcum

stances in

o ld

e r to

d e

te rm

in e

th e

e xte

n t o

f th e

w o

m a

n 's

responsibility, and hence the extent of heÿ obligation T

his is an extrem ely unsatisfactoly outcom

e, fiom the

vie w

p o

in t o

f th e

o p

p o

n e

n ts o

f re strictive

a b

o rtio

n law

s, m ost of w

hom aie convinced that a w

om an has

a ilg

h t to

o b ta

in a

n a

b o ltio

n re

g a rd

le ss o

f h o w

a n d

w hy she got piegnant.

O f course a suppoIter of the violinist analogy nught

point out that it is absurd to suggest that foxgetting her pill one day m

ight be sufficient to obligate a w om

an to com

plete an unw anted pregnancy. A

nd indeed It ts absuid to suggest this A

s w e shall see, the m

oral right to

o b ta

in a

n a

b o m

o n is n

o t in

th e le

a st d

e p e n d e n t

upon the extent to w hich the w

om an is iesponsible fol

her pregnancy. B ut unfortunately, once w

e allow the

assum ption that a fetus has full m

ol al rights, w e cannot

avoid taking this absuid suggestion S ellously P

eihaps w

e can m ake this point m

ore clear by alteling the V lO

- hnlst story just enough to m

ake it m oxe analogous to

a nolm al unw

anted plegnancy and less to a pIegnancy d u e to

la p e , a

n d th

e n se

e in

g w

h e th

e l it is still o

b vi-

fe llo

w .

S uppose, then, that viohnlsts m

e peculiarly prone to the S

O lt of Illness the only cule for w

hich is the use of som

eone else's bloodstleam for nine m

onths, and that because of this there has been form

ed a society of m

usic lovels w ho agIee that w

henever a violinist IS stiicken they w

ill diaw lots and the losei w

ill, by som

e m eans, be m

ade the one and only person capa- ble of saving him

. N ow

then, w ould you be obligated

to cooperate in C U

llng the viohm st ff you had volun-

tardy joined this society, know ing the possible conse-

quences, and then your nam e had been dtaw

n and you had been kidnapped9 A

dm ittedly, you did not prom

ise ahead of tim

e that you w ould, but you did dehberately

place youlself In a position in w hich It m

ight happen that a hum

an life w ould be lost If you did not S

uiely this IS

at least a piim a facie reason foi supposing that

you have an obhgation to stay in bed w ith the w

olin- ist. S

u p p o se

th a t yo

u h

a d g

o tte

n yo

u r n

a m

e d

ra w

n dehbei ately; surely that w

ould be quite a strong reason for thinking that you had such an obligation.

It m ight be suggested that there is one im

poitant dlsanalogy betw

een the m odified vlohnist case and

the case of an unw anted plegnancy, w

hich m akes the

w om

an's responsibility significantly less, nam ely, the

fact that the fetus com es into existence as the Iesult of

the w om

an's actions. T his fact m

ight give her a right to iefuse to keep it alive, w

hereas she w ould not have

had this right had it existed pleviously, independently, and then as a result of her actions becom

e dependent upon her for its surw

val M

y o w

n In

tu itio

n , h

o w

e ve

l, is th a t x h

a s n

o m

o re

right to bring into existence, either delibel ately or as a foreseeable lesult of actions he could have avoided, a being w

ith full m oral rights (y), and then refuse to

do w hat he knew

beforehand w ould be required to

ke e

p th

a t b

e in

g a

live , th

a n

h e

h a

s to e

n te

r in to

a n

agleem ent w

ith an existing person, w hereby he m

ay b e ca

lle d u

p o n to

sa ve

th a t p

e lso

n 's life

, a n d th

e n

xefuse to do so w hen so called upon T

hus, x's respon- slbihty fol y's existence does not seem

to lessen his obhgation to keep y alive, If he IS

also responsible foI y's being In a situation in w

hich only he can save him W

hetheÿ o1" not this intuition IS entirely collect, it

bnngs us back once again to the conclusion that once w

e allow the assum

ption that a fetus has full m oral

rights It becom es an extlem

ely com plex and difficult

q u e stio

n w

h e th

e r a

n d w

h e n a

b o rtio

n is ju

stifia b le

. Thus the Thom

son analogy cannot help us produce a cleal and persuasive proof of the m

oral petm lsslblhty

O 1

. O tu

tJtttu lt, l.xu

t "€ €

itt ttJ,',.., 'd lJF

u li,...,lltb

t.lI tile re

s'trlC l;lve

law s thank us for anything less; foi their conviction

(for the m ost part) is that aboltlon is obviously not

a m

o ra

lly se iio

u s a

n d e

xtre m

e ly u

n fo

ltu n a te

, e ve

n though som

etim es justified act, com

palable to killing in self-defense or to letting the violinist die, but Iather is clo

se l to

b e in

g a

m o la

lly n e u tra

l a ct, like

cu ttin

g o

n e 's h

a ir.

T he basis of this conviction, I beheve, is the leal-

lzation that a fetus is not a person, and thus does not have a full-fledged right to life. P

erhaps the reason w

hy this claim has been so inadequately defended is

that it seem s self-evident to those w

ho accept it. A nd

so it is, in

so fa

r a s it fo

llo w

s flo m

w h

a t I ta

ke to

b e

perfectly obvious claim s about the nature of person-

h o

o d

, a n

d a

b o

u t th

e p

ro p

e r g

ro u

n d

s fo r a

scrib in

g m

oral nghts, clm m

s w hich ought, indeed, to be obvious

to both the friends and foes of abortion. N evertheless, it

is w orth exarm

ning these claim s, and show

ing how they

d e m

o n stra

te th

e m

o ra

l ln n o cu

o u sn

e ss o

f a b o m

o n ,

since this apparently has not been adequately done before

II T

he question w hich w

e m ust answ

er in oider to pro- duce a satisfactory solutm

n to the pxoblem of the

m oral status of aboxtion is this: H

ow aIe w

e to define the m

oral com m

unity, the set of beings w ith full and

equal m oral rights, such that w

e can decide w hethei a

hum an fetus ÿs a m

em ber of this com

m unity or not?

W hat sort of entity, exactly, has the inalienable rights

to life, liberty, and the pursuit of happiness9 Jeffel son atm

buted these rights to all m en, and it m

ay or m ay

not be fair to suggest that he intended to attribute them

only to m en P

eihaps he ought to have attributed them

to all hum an beings. If so, then w

e arnve, first, at N

oonan's problem of defining w

hat m akes a being

hum an, and second, at the equally vital question w

hich N

oonan does not consider, nam ely, W

hat ieason is theie for Identifying the m

oral com m

unity w ith the

se t o

f a ll h

u m

a n b

e in

g s, in

w h a te

ve r w

a y w

e h

a ve

chosen to define that term ?

O N

T H

E D

E F

IN IT

IO N

O F

"H U

M A

N "

O ne reason w

hy this vital second question is so fre- quently overlooked in the debate over the m

oi al status of abortion ÿs that the term

"hum an" has tw

o dÿstinct, but not often distinguished, senses. T

his fact results in a slide of m

eaning, w hich selves to conceal the falla-

C lO

usness of the tladitional argum ent that since (1) it

is w rong to kill innocent hum

an beings, and (2) fetuses

M A

R Y

A N

N E

W A

R R

E N

ÿ'] 1

axe innocent hum an beings, then (3) it is w

Iong to kill fetuses F

ol if "hum an" is used in the sam

e sense in both (1) and (2) then, w

hichever of the tw o senses IS

m e a n t, o

n e o

f th e se

p re

m ise

s is q u e stio

n -b

e g g in

g .

A nd if it IS

used in tw o dlffeient senses, then of couise

the conclusion doesn't follow T

hus, (1) is a self-evident m oral truth,3 and avoids

begging the question about abortion, only if "hum an

being" is used to m ean som

ething like "a full-fledged m

em ber of the m

olal com m

unity." (It m ay ol m

ay not also be m

eant to refel exclusively to m em

bers of the species H

om o sapiens.) W

e m ay call this the m

oral sense of "hum

an" It is not to be confused w ith w

hat w

e w ill call the genetic sense, I.e., the sense in w

hich any m

em bei of the species is a hum

an being, and no m

em ber of any other species could be. If (1) is accept-

able only if the m otal sense is intended, (2) is non-

question-begging only if w hat is intended is the

genetic sense. In "D

eciding W ho Is H

um an," N

oonan aigues for the classification of fetuses w

ith hum an beings by

pointing to the presence of the full genetic code, and the potential capacity fol rational thought (p. 135) It is clear that w

hat he needs to show , fol his veisÿon of

the traditional argum ent to be valid, is that fetuses are

h u

m a

n in

th e

m o

xa l se

n se

, th e

se n

se in

w h

ich it is

analytically true that all hum an beings have full m

oral rights B

ut, in the absence of any argum ent show

ing that w

hatever is genetically hum an ÿs also m

orally hum

an, and he gives none, nothing m ole than genetic

hum anity can be dem

onstiated by the pIesence of the hum

an genetic code. A nd, as w

e w ill see, the poten-

tia l ca

p a

city fo r la

tlo n

a l th

o u

g h

t ca n

a t m

o st sh

o w

that an entity has the potential for becom ing hum

an in the m

oral sense

D EFIN

IN G

TH E M

O R

AL C O

M M

U N

ITY

C an it be established that genetic hum

anity is suffi- cient for m

oral hum am

ty9 I think that there ate veIy good reasons for not defining the m

oral com m

um ty in

this w ay. I w

ould like to suggest an alternative w ay of

defining the m oxal com

m unity, w

hich I w all algue fol

only to the extent of explaining w hy it is, or should

b e

, se lf-e

vid e

n t T

h e

su g

g e

stio n

a s sim

p ly th

a t th

e m

o ra

l co m

m u n ity co

n sists o

f a ll a

n d o

n ly p

e o p le

, rather than all and only hum

an beings;4 and piobably the best w

ay of dem onstlatIng its self-evidence is by

considering the concept of personhood, to see w hat

sorts of entity aIe and are not persons, and w hat the

372 R EPR

O D

U C

TIO N

d e cisio

n th

a t a

b e in

g is o

i IS n

o t a

p e lso

n im

p lie

s about its m

oral nghts.

W h

a t m

o ra

l ch a

ra cte

n stics e

n title

a n

e n

tity to b

e considered a person? T

his is obviously not the place to attem

pt a com plete analysis of the concept of pei-

sonhood, but w e do not need such a fully adequate

analysis just to determ ine w

hether and w hy a fetus is

O l isn't a peison. A

ll w e need is a rough and applox-

im a te

list o f th

e m

o st b

a sic cu

te Ila

o f p

e rso

n h o o d ,

a n

d so

m e

id e

a o

f w h

ich , o

r h o

w m

a n

y, o f th

e se

a n

entity m ust satisfy in older to propeily be considered

a pelson

In se

a rch

in g fo

l su ch

crIte n a , it a

s u se

fu l to

lo o k

b e yo

n d th

e se

t o f p

e o p le

w ith

w h o m

w e a

ie a

c- q u a in

te d , a

n d a

sk h o w

w e w

o u ld

d e cid

e w

h e th

e l a

totally alien being w as a pelson oi not. (F

or w e have

no right to assum e that genetic hum

anity is necessary fol personhood.) Im

agine a space traveler w ho lands

on an unknow n planet and encountels a race of beings

uttelly unlike any he has evel seen O l heald of If he

w a

n ts to

b e

su le

o f b

e h

a vin

g m

o la

lly to w

a rd

th e

se beings, he has to som

ehow decide w

hether they are people, and hence have full m

oial rights, or w hethel

they ale the sort of thing w hich he need not feel guilty

about tleatlng as, for exam ple, a souIce of food.

H ow

should he go about m aking this decision9 If

he has som e anthropological background he m

ight lo

o k fo

l su ch

th in

g s a

s re lig

io n

, a rt, a

n d

th e

m a

n u

- facturing of tools, w

eapons, or shelters, since these factors have been used to distinguish O

U l hum

an flora oui prehum

an ancestols, in w hat seem

s to be closer to the m

oral than the genetic sense of "hum an." A

nd no doubt he w

ould be nght to consider the plesence of such factors as good evidence that the alien beings w

ele people, and m orally hum

an. It w ould, how

ever, be oveily anthIopocentric of him

to take the absence of these things as adequate evidence that they w

ere not, since w

e can im agine people w

ho have proglessed b

e yo

n d

, o r e

vo lve

d w

ith o

u t e

ve l d

e ve

lo p

in g

, th e

se cultulal chalacteustlcs

I suggest that the traits w hich aie m

ost central to the concept of pelsonhood, O

l hum anity in the m

olal sense, are, vely loughly, the follow

ing.

3 S

e lf-m

o tiva

te d a

ctivity (a ctivity w

h ich

IS rÿ

tlve ly in

d e

p e

n d

e n

t o f e

ith e

r g e

n e

tic o i d

ire ct'!ÿ

e xte

In a

l co n

tio l);

4 T

h e

ca p

a city to

co m

m u

n ica

te , b

y w h

a te

ve r

m e a n s, m

e ssa

g e s o

f a n In

d e fin

ite va

u e ty o

f types, that is, not just w

ith an Indefinite num ber

of possible contents, but on indefinitely m any

possible topics; 5 T

he piesence of self-concepts, and self-aw are_

ness, elthei individual or Iaclal, oi both

not only that (1)-(5) are central to the concept of personhood, but also that it is a pair of this concept that all and only people have full m

oial rights. The concept of a pelson is In palt a m

oial concept; once w

e have adm itted that x is a pelson w

e have recog- nized, even If w

e have not agleed to lespect, x's nght to be tleated as a m

em bel of the m

olal com m

unity It is true that the claim

that x is a hum an being is m

ole com

m only voiced as pait of an appeal to tieat a de-

cently than is the claim that x is a pelson, but this IS

eithel because "hum an being" is hele used in the sense

w hich im

phes personhood, oi because the genetic and m

oral senses of "hum an" have been confused

N ow

If (1)-(5) aie indeed the prim ary critena of

peisonhood, then it is cleal that genetic hum anity is

neitheI necessaiy nor sufficient for establishing that a n e

n tity is a

p e Iso

n S

o m

e h

u m

a n b

e in

g s a

Ie n

o t

p e

o p

le , a

n d

th e

ie m

a y w

e ll b

e p

e o

p le

w h

o a

le n

o t

hum an beings. A

m an or w

om an w

hose conscious- ness has been perm

anently obhtelated but w ho re-

m a in

s a live

is a h

u m

a n b

e in

g w

h ich

IS n

o lo

n g e i a

peison, defective hum an beings, w

ith no appleclable m

ental capacity, are not and presum ably never w

ill be people, and a fetus is a hum

an being w hich is not yet

a pelson, and w hich theiefore cannot cohelently be

said to have full m oIal rights C

itizens of the next cen- tuly should be plepared to lecognize highly advanced, self-aw

aIe iobots or com putels, should such be devel-

o p e d , a

n d ln

te lh

g e n t in

h a b ita

n ts o

f o th

e i w

o lld

s, should such be found, as people in the fullest sense, a n d to

re sp

e ct th

e ir m

o ra

l rig h ts. B

u t to

a scrib

e fu

ll m

o ra

l rig h ts to

a n e

n tity w

h ich

is n o t a

p e lso

n is a

s absurd as to asciibe m

olal obligations and responsl- blhtIes to such an entity.

M A

R Y

A N

N E

W A

R R

E N

373

1. C onsciousness (of objects and events external

and/oi Internal to the being), and in palticular the capacity to feel pain;

2. R easoning (the developed capacity to solve new

and ielatively com plex problem

s);

FETAL D EVELO

PM EN

T AN D

TH E R

IG H

T TO LIFE

T w

o problem s arise in the apphcatlon of these sug-

gestions for the definition of the m oial com

m unity to

th e

d e

te rm

in a

tio n

o f th

e p

Ie clse

m o

ra l sta

tu s o

f a hum

an fetus G iven that the pm

adigm exam

ple of a person is a nolm

al adult being, then (1) H ow

like this paladlgm

, in particular how far advanced since con-

ce p tio

n , d

o e s a

h u m

a n b

e in

g n

e e d to

b e b

e fo

le it

b e g in

s to h

a ve

a rig

h t to

life b

y V lltU

e , n

o t o

f b e in

g fully a person as of yet, but of being hke a peison? and (2) To w

hat extent, if any, does the fact that a fetus has the potential foi becom

ing a pelson endow it w

ith som e of the sam

e rights9 E ach of these ques-

tions iequlres som e com

m ent

In answ eung the first question, w

e need not attem pt

n c

to tn

llo c l o

n n ÿ rto

rn tln

n n

f th @

m n ln

l rlc rh

tÿ n

f n ro

n n -

A dm

ittedly, thele are apt to be a gieat m any prob-

le m

s In vo

lve d

in fo

lm u

la tln

g p

re cise

d e

fin itio

n s o

f these criteria, let alone in developing universally valid behavloial criteria foi deciding w

hen they apply. B ut

I w ill a

ssu m

e th

a t b

o th

w e

a n

d O

U l e

xp lo

ie r kn

o w

appIoxIm ately w

hat (1)-(5) m ean, and that he is also

a b le

to d

e te

rm in

e w

h e th

e r o

i n o t th

e y a

p p ly. H

o w

, then, should he use his findings to decide w

hether or not the alien beings ale people9 W

e needn't suppose that an entity m

ust have all of these attllbutes to be properly consideled a peison; (1) and (2) alone m

ay w

ell be sufficient foi pelsonhood, and quite plobably (1)-(3) aIe sufficient. N

either do w e need to Insist that

any one of these criteua IS necessal3, foi pelsonhood,

although once again (1) and (2) look like fairly good ca

n d id

a te

s fo r n

e ce

ssa ly co

n d itio

n s, a

s d o e s (3

), if "activity" is construed so as to Include the activity of

reasoning

A ll w

e need to claim , to dem

onstiate that a fetus is not a person, IS

that any being w hich satisfies none

of (1)-(5) is certainly not a pelson I consldei this claim

to be so obvious that I think anyone w ho denied

it, a n

d cla

im e

d th

a t a

b e

in g

w h

ich sa

tisfie d

n o

n e

o f

(1)-(5) w as a person all the sam

e, w ould thereby

d e m

o n stia

te th

a t h

e h

a d n

o n

o tio

n a

t a ll o

f w h a t a

person ls--peihaps because he had confused the con- cept of a peIson w

ith that of genetic hum anity If the

opponents of aboition w ere to deny the appIopnate-

ness of these five cntena, I do not know w

hat further argum

ents w ould convince them

W e w

ould probably have to adm

it that our conceptual schem es w

eie indeed ineconcilably different, and that our dispute could not be settled objectively

I d o

n o

t e xp

e ct th

is to h

a p

p e

n , h

o w

e ve

i, sin ce

I think that the concept of a person is one w

hich is very nearly unIveisal (to people), and that it is com

m on to

both proaboltionlsts and antIabortionists, even though neithei gioup has fully realized the Ielevance of this concept to the lesolutlon of their dispute F

ulthelm oie,

I th in

k th a

t o n

le fle

ctlo n e

ve n

th e

. n n

tln h

o ÿ tÿo

n lÿfÿ n

n a

h t

ism s w

hich ale not developed enough, aw aie enough,

intelligent enough, etc, to be consideled people, but w

hich iesem ble people in som

e respects. It does seem leasonable to suggest that the m

ole like a person, In the relevant aspects, a being is, the stiongei is the case fo

i ie g a id

in g it a

s h a vin

g a

lig h t to

life , a

n d in

d e e d

the S tlongei its right to life is. T

hus w e ought to take

seriously the suggestion that, insofar as "the hum an

in d ivid

u a l d

e ve

lo p s b

io lo

g ica

lly in a

co n tin

u o u s

fashion .. the rights of a hum an person m

ight develop in the sam

e w ay.''5 B

ut w e m

ust keep in m ind that the

attributes w hich aIe ielevant In deteim

inlng w hether

oi not an entity IS enough like a person to be legaided

as having som e of the sam

e m oIal rights aie no dif-

fe re

n t flo

m th

o se

w h ich

a Ie

le le

va n t to

d e te

rm in

in g

w h

e th

e r o

r n o

t it is fu lly a

p e

lso n

--1 e

., a Ie

n o

t d if-

fe re

n t fro

m (1

)-(5 )--a

n d th

a t b

e in

g g

e n e tica

lly hum

an, oi having recognizably hum an facial and othei

physical features, O l detectable blain activity, or the

capacity to S U

lvive outside the uteius, aie sim ply not

am ong these lelevant attlibutes T

hus it is cleal that even though a seven- oi eight- m

onth fetus has features w hich m

ake it apt to aiouse in us alm

ost the sam e pow

erful protective Instinct as is com

m only aroused by a sm

all infant, neveitheless it is n

o t sig

n ifica

n tly m

o le

p e lso

n h ke

th a n is a

ve iy

sm all em

biyo It is som ew

hat m ore pelsonhke; it can

appaiently feel and lespond to pain, and it m ay even

have a iudIm entaIy form

of consciousness, Insofai as ItS

brain is quite active N evertheless, it seem

s safe to sa

y th a t it is n

o t fu

lly co n scio

u s, in

th e w

a y th

a t a

n infant of a few

m onths IS

, and that it cannot reason, O

l com m

unicate m essages of indefinitely m

any soits, does not engage in self-m

otivated activity, and has no self-aw

aleness T hus, in the ÿelevant respects, a fetus,

even a fully developed one, IS consideiably less per-

sonhke than is the average m atuIe m

am m

al, indeed th

e a

ve ra

g e fish

. A n d I th

in k th

a t a

ia tlo

n a l p

e iso

n m

ust conclude that if the nght to life of a fetus is to b e b

a se

d u

p o n its re

se m

b la

n ce

to a

p e rso

n , th

e n it

cannot be said to have any m ole nght to life than, let

u s sa

y, a n

e w

b o

rn g

u p

p y (w

h ich

a lso

se e

m s to

b e

capable of feehng pain), and that anght of that m ag-

nitude could never overude a w om

an's right to obtain an abortion, at any stage of her plegnancy

T heIe m

ay, of course, be othel aigum ents in favor

of placing legal lim its upon the stage of pIegnancy

in w

h ich

a n

a b

o ltIo

n m

a y b

e p

e lfo

rm e

d G

ive n

th e

la ln

tlv ÿ ÿ

n fÿ

tv o

f" th ÿ n

e w

te ,e

h m

n u

e ÿ o

f a ltlfic

la llv

374 R E

P R

O D

U C

T IO

N

in d u cin

g la

b o i d

u rin

g th

e th

ird trlm

e ste

i, th e d

a n g e i

to th

e w

o m

a n 's life

o l h

e a lth

IS n

o lo

n g e l su

ch a

n a lg

u m

e n t. N

e lth

e i IS

th e fa

ct th a t p

e o p le

te n d to

tespond to the thought of abortion in the latel stages o

f p re

g n

a n

cy w ith

e m

o tio

n a

l re p

u lsio

n , sin

ce m

e re

em otional responses cannot take the place of m

olal re

a so

n in

g In

d e te

rm in

in g w

h a t o

u g h t to

b e p

e rm

it- te

d . N

o l, fin

a lly, is th

e fre

q u

e n

tly h e

a rd

a l'g

u m

e n

t that legalizing abortion, especially late in the preg- n

a n

cy, m a

y e lo

d e

th e

le ve

l o f re

sp e

ct fo r h

u m

a n

life , le

a d in

g , p

e rh

a p s to

a n in

cre a se

in u

n ju

stifie d

e u

th a

n a

sia a

n d

o th

e l cIlm

e s. F

o l th

is th le

a t, if it is

a th

re a

t, ca n

b e

b e

tte r m

e t b

y e d

u ca

tin g

p e

o p

le to

the kinds of m oral distinctions w

hich w e ale m

aking here than by lim

iting access to abortion (w hich lim

- itation m

ay, in its dIslegard for the rights of w om

en, be just as dam

aging to the level of lespect fol hum an

rights) Thus, since the fact that even a fully developed

fetus is not pelsonlike enough to have any significant nght to life on the basis of its person-likeness show

s that no legal restrictions upon the stage of pregnancy in w

hich an abortion m ay be perform

ed can be justi- fied on the glounds that w

e should piotect the rights of the older fetus; and since there is no other appar- e n t ju

stifica tio

n fo

r su ch

re stn

ctIo n s, w

e m

a y co

n -

clude that they ale entirely unjustified W hethel or not

It w ould be indecent (w

hatevei that m eans) fol a

w o m

a n in

h e r se

ve n th

m o n th

to o

b ta

in a

n a

b o itlo

n just to avoid having to postpone a trip to E

m ope, It

w ould not, m

itself, be Im m

oral, and therefore It ought to be pelm

ttted

PO TEN

TIAL PER SO

N H

O O

D AN

D TH

E R IG

H T TO

LIFE

W e have seen that a fetus does not lesem

ble a peIson m

any w ay w

hich can suppoit the claim that it has

e ve

n so

m e o

f th e sa

m e rig

h ts. B

u t w

h a t a

b o u t its

potential, the fact that if nultured and allow ed to

develop naturally It w ill very plobably becom

e a peison9 D

oesn't that alone give it at least som e right

to life? It is haId to deny that the fact that an entity is a potential pelson is a strong prim

a facie reason for not destloying it; but w

e need not conclude from this

that a potential pelson has a right to life, by virtue of that potential. It m

ay be that our feeling that it is better, othei things being equal, not to destl oy a poten- tial peIson is better explained by the fact that poten- U

al people ale still (felt to be) an invaluable resource,

dustw e

le a

p o

te n

tia l p

e is

o n

, w e

w o

u ld

b e

m u

c h

lÿ apt to conclude that evely potential peison has a rightÿ to

b e

c o

m e

a c tu

a l ÿ

ii S

till, w e do not need to insist that a potential person

has no right to life w hatevel T

here m ay w

ell be som e-

th in

g im

m o

ia l, a

n d

n o

t ju st im

p ru

d e

n t, a

b o

u t w

a n

- tonly destioying potential people, w

hen doing so isn't n

e ce

ssa ry to

p ro

te ct a

n yo

n e

's n g

h ts B

u t e

ve n

if a potential person does have som

e pum a facie right to

life, such a right could not possibly outw eigh the right

of a w om

an to obtain an abortion, since the rights of any actual person invariably outw

eigh those of any potential person, w

henevel the tw o conflict. S

ince this m

a y n

o t b

e Im

m e

d ia

te ly o

b vio

u s In

th e

ca se

o f a

h u m

a n fe

tu s, le

t u s lo

o k a

t a n o th

e r ca

se . ÿ

Suppose that O U

l space explorer falls into the hands of an allen culture, w

hose scientists decide to create a few

hundled thousand or m ore hum

an beings, by bleakm

g his body m to its com

ponent cells, and using these to create fully developed hum

an beings, w ith,

o f co

u rse

, h is g

e n

e tic co

d e

W e

m a

y im a

g in

e th

a t

each of these new ly created m

en w ill have all of the

original m an's abilities, skills, know

ledge, and so on, and also have an individual self-concept, in short that each of them

w ill be a bona fide (though hardly

unique) peIson. Im agine that the w

hole project w ill

take only seconds, and that its chances of success are e xtre

m e ly h

ig h , a

n d th

a t o

u r e

xp lo

re r kn

o w

s a ll o

f this, and also know

s that these people w ill be treated

fa irly. I m

a in

ta in

th a

t in su

ch a

situ a

tio n

h e

w o

u ld

have eveiy right to escape if he could, and thus to depnve all of these potential people of their potential lives, for his right to life outw

eighs all of theirs together, in spite of the fact that they ate all geneti- ca

lly h u

m a

n , a

ll in n

o ce

n t, a

n d

a ll h

a ve

a ve

ry h ig

h probability of becom

ing people very soon, ff only he re

fra in

s flo ra

a ctio

n Indeed, I think he w

ould have a right to escape e

ve n

if it w e

re n

o t h

is life w

h ich

th e

a lie

n scie

n tists

p la

n n

e d

to ta

ke , b

u t o

n ly a

ye a

r o f h

is fre e

d o

m , o

r, indeed, only a day. N

or w ould he be obligated to stay

if he had gotten captured (thus bringing all these people-potentials into existence) because of his ow

n carelessness, or even if he had done so deliberately, know

ing the consequences R egardless of how

he got captured, he is not m

orally obhgated to lem ain In cap-

tIvity for any period of tim e for the sake of perm

itting any num

bel of potential people to com e into actual-

ity, so great is the m argin by w

hich one actual person's nght to liberty outw

eighs w hatever nghts to life even

se e

m s Ie

a so

n a

b le

to co

n clu

d e

th a

t th e

H g

h ts o

f a w

o m

a n

w ill o

u tw

e ig

h b

y a sim

ila i m

a lg

ln w

h a

te ve

r right to hfe a fetus m

ay have by vntue of its potential pelsonhood.

T h u s, n

e ith

e i a

fe tu

s's ie se

m b la

n ce

to a

p e lso

n ,

nor its potentm l for becom

ing a person provides any basis w

hateveI foi the clm m

that it has any significant right to life C

onsequently, a w om

an's iight to protect her health, happiness, freedom

, and even her hfe,6 by term

inating an unw anted pregnancy w

ill alw ays over-

ride w hatevel right to life it m

ay be appiopnate to a

scrib e

to a

fe tu

s, e ve

n a

fu lly d

e ve

lo p

e d

o n

e . A

n d

thus, In the absence of any overw helm

ing social need for every possible child, the law

s w hich restrict the

right to an abortion, or lim it the period of pregnancy

d n n n g w

h ich

a n a

b o rtio

n m

a y b

e p

e rfo

rm e d , a

re a

w holly unjustified violation of a w

om an's m

ost basic m

oral and constitutional rights]

PO STSCRIPT O

N INFANTICIDE S

ince the publication of this [essay], m any people

have w ritten to point out that m

y argum ent appears to

justify not only aboltlO n, but infanticide as w

ell For a new

-born infant is not significantly m ole pelsonhke

than an advanced fetus, and consequently It w ould

seem that if the destruction of the latteI IS peim

issm ble

so too m ust be that of the folm

eI. Inasm uch as m

ost people, regaldless of how

they feel about the m olal-

ity of abortion, consider infanticide a form of m

urder, th

is m ig

h t a

p p

e a

r to re

p re

se n

t a se

rio u

s fla w

in m

y argum

ent. N

ow , ff I am

tight in holding that It is only people w

ho have a full-fledged right to life, and w ho can be

m u

rd e

ie d

, a n

d if th

e crite

ria o

f p e

lso n

h o

o d

a re

a s I

have described them , then It obviously follow

s that killin

g a

n e w

-b o rn

in fa

n t isn

't m u rd

e r It d

o e s n

o t

fo llo

w , h

o w

e ve

r, th a t in

fa n ticid

e is p

e rm

issib le

, fo r

tw o reasons. In the first place, it w

ould be w long, at

least in this country and in this period of history, and o th

e r th

in g s b

e in

g e

q u a l, to

kill a n

e w

-b o rn

in fa

n t,

because even if its patents do not w ant it and w

ould not suffei from

its destruction, theie are other people w

ho w ould hke to have it, and w

ould, in all probabil- ity, be deprived of a great deal of pleasure by its d

e stru

ctm n

T h

u s, in

fa n

ticid e

is w io

n g

fo r le

a so

n s

analogous to those w hich m

ake it w long to w

antonly destroy natulal iesouices, ol great w

orks of air S

e co

n d ly, m

o st p

e o p le

, a t le

a st in

th is co

u n tly,

value infants and w ould m

uch prefei that they be p

re se

lve d

, e ve

n if fo

ste i p

a re

n ts a

re n

o t im

m e

d I-

M A

R Y

A N

N E

W A

R R

E N

375

su p p o it o

lp h a n a g e s th

a n a

llo w

u n w

a n te

d in

fa n ts to

be destroyed. S o long as thele aie people w

ho w ant

an infant pleserved, and w ho are w

illing and able to p lo

vld e th

e m

e a n s o

f ca rin

g fo

l it, u n d e r le

a so

n a b ly

h u m

a n e co

n d itio

n s, it is, ce

rte rts p

a rtb

u s, w

ro n g to

destroy it B

u t, it m

ig h

t b e

le p

h e

d , if th

is a rg

u m

e n

t sh o

w s

th a

t in fa

n ticid

e is w

ro n

g , a

t le a

st a t th

is tim e

a n

d in

th is co

u n tiy, d

o e sn

't it a lso

sh o w

th a t a

b o ltm

n is

w rong? A

ftel all, m any people value fetuses, are dis-

tu rb

e d b

y th e ir d

e sttu

ctlo n , a

n d w

o u ld

m u ch

p ie

fe i

that they be preserved, even at som e cost to them

- selves. F

urtherm oie, as a potential souice of pleasure

to som e foster fam

ily, a fetus is just as valuable as an m

fant T hete is, how

ever, a crucial diffelence betw een

the tw o cases so long as the fetus is unbom

n, its presei- ration, contlm

y to the w ishes of the piegnant w

om an,

violates heI nghts to freedom , happiness, and selfde-

te xm

ln a

tio n

. H e

r rig h

ts o ve

rn d

e th

e n

g h

ts o f th

o se

w ho w

ould like the fetus preserved, just as if som e-

o n

e 's life

o r lim

b is th

ie a

te n

e d

b y a

w ild

a n

im a

l, h is

right to protect him self by destioylng the anim

al ovel- rides the Lights of those w

ho w ould prefer that the

anim al not be harm

ed T

he m inute the infant is born, how

eveL its plesel- va

tlo n

n o

lo n

g e

l vio la

te s a

n y o

f its m o

th e

l's n g

h ts,

even if she w ants it destioyed, because she is free to

put It up for adoption. C onsequently, w

hile the m om

ent of bnth does not m

ark any shalp discontinuity in the degree to w

hich an infant possesses the right to life, It does m

alk the end of its m other's right to detelm

m e

its fa te

In d e e d , if a

b o ltio

n co

u ld

b e p

e rfo

lm e d w

ith -

out killing the fetus, she w ould nevel possess the light

to have the fetus destroyed, foi the sam e reasons that

she has no light to have an infant destroyed. O

n th

e o

th e

i h a

n d

, it fo llo

w s fro

m m

y a rg

u m

e n

t th

a t w

h e n a

n u

n w

a n te

d o

r d e fe

ctive in

fa n t is b

o rn

in to

a so

cie ty w

h ich

ca n

n o

t a ffo

rd a

n d

/o I is n

o t w

ill- m

g to

ca re

fo l it, th

e n

its d e

stru ctio

n is p

e lm

lssib le

T his conclusion w

ill, no doubt, strike m any people as

h e

a ltle

ss a n

d im

m o

ra l, b

u t re

m e

m b

e l th

a t th

e ve

iy e xiste

n ce

o f p

e o p le

w h o fe

e l th

is w a y, a

n d w

h o a

le w

illing and able to plovide caIe for unw anted infants,

is reason enough to conclude that they should be preserved.

N O

TES 1 JudU

h Thom son. "A

D efense of A

bom on," P

hilosophy, and

376 R E

P R

O D

U C

T IO

N

2 W e m

ay safely lgnole the fact that she m ight have avoided

g e ttin

g 1

a p e d , e

g , b

y ca u yln

g a

g u n , sin

ce b

y sn n ila

r m e a n s yo

u m

ight hkew lse have avoided getting kidnapped, and in nelthe! case

d o e s th

e victim

's fa llu

ie to

ta ke

a ll p

o ssib

le p

re ca

u tio

n s a

g a in

st a highly unlikely event (as opposed to leasonable precautions against a ÿathel likely event) m

ean that he is m orally responsible for w

hat happens

3 O f course, the pllnclple that it is (alw

ays) w long to kill

in n o ce

n t h

u m

a n b

e in

g s is in

n e e d o

f m a n y o

th e l m

o d ifica

tio n s, e

g ,

that it m ay be perm

issible to do so to save a greatei num bel of other

in n o ce

n t h

u m

a n b

e in

g s, b

u t w

e m

a y sa

fe ly lg

n o le

th e se

co m

p lica

- tio

n s h

e le

4 F

ro m

h e

le o

n , w

e w

ill u se

"h u

m a

n " to

m e

a n

g e

n e

tica lly

hum an, since the nloÿal sense seem

s closely connected to, and per- h a p s d

e llve

d fro

m , th

e a

ssu m

p tio

n th

a t g

e n e tic h

u m

a n ity is su

ffi- cie

n t fo

r m e m

b e rsh

ip in

th e m

o la

l co m

m u n ity

5 T

h o m

a s L

H a y e s , "A

B io

lo g ic

a l V

ie w

," C o m

m o n w

e a l,

85 (M arch 17, 1967), 677-78, quoted by D

aniel C allahan, In

A b m

tlo n , L

a u ; C

h o ice

, a n d M

o la

h ty (L

o n d o n M

a cm

illa n &

C o

, 1 9

7 0 ) ÿ

i 6 T

h a t is, ln

so fa

l a s th

e d

e a th

la te

, fo l th

e w

o m

a n , is h

ig h e r

fm childbirth than for early aboltlO

n 7 M

y thanks to the follow ing people, w

ho w ere kind enough

to re

a d

a n

d criticize

a n

e a

lh e

r ve lslo

n o

f th is p

a p

e i H

e lb

e rt G

o ld

, G

ene G lass, A

nne Lautelbach, Judith Thom son, M

aiy M otherslll,

and T im

othy B lnkley

Legal Issues S urrounding A

bortion

R O

E v

. W A

D E

U nited S

tates S uprem

e C ourt, 1973

JU S

TIC E

B LA

C K

M U

N dehvered the opinion of the C

ourt

It is... a p

p m

e n

t th a

t a t co

m m

o n

la w

, a t th

e tim

e o

f the adoption of O

U l C

onstitution, and thxoughout the m

ajol pO ltlO

n of the nineteenth century, abortion w as

view ed w

ith less disfavor than under m ost A

m erican

statutes cunently in effect. P hiaslng it anothei w

ay, a w

o m

a n e

n jo

ye d a

su b sta

n tia

lly b ro

a d e r rig

h t to

te r-

m inate a piegnancy than she does In m

ost states today. A

t least w ith respect to the early stage of pregnancy,

and vely possibly w ithout such a lim

itation, the oppor- tunity to m

ake this choice w as present in this countiy

w ell Into the nineteenth centm

y. E ven later, the law

co n

tin u

e d

fo i so

m e

tim e

to tre

a t le

ss p u

n itive

ly a n

abortion procm ed in early pregnancy . . .

T hiee leasons have been advanced to explain his-

to rica

lly th e e

n a ctm

e n t o

f crim in

a l a

b o m

o n la

w s m

the nineteenth centuiy and to justify their continued e xiste

n ce

.

It h a s b

e e n a

ig u e d o

cca sio

n a lly th

a t th

e se

la w

s w

e re

th e

p ro

d u

ct o f a

V icto

ria n

so cia

l co n

ce rn

to

R epnnted from

410 U nited S

tates R epot ts 113 decided Janualy 22,

1973

discourage illicit sexual conduct T exas, how

ever, does not advance this justxfication in the plesent case, and It appeais that no court or com

m entatol has taken the

argum ent senously..

A second reason is concerned w

ith aboition as a m

edical procedure. W hen m

ost cnm inal aboi tion law

s w

ere first enacted, the procedm e w

as a hazaxdous one for the w

om an T

his w as paitlcularly true prior to the

developm ent of antisepsis. A

ntisepnc techm ques, of

couise, w eie based on discoveiies by Listel, P

asteur, and othels filS

t announced in 1867, but w ere not gen-

exally accepted and em ployed until about the turn of

th e ce

n tm

y A b o rtio

n m

o rta

h ty w

a s h

ig h . E

ve n a

fte r

1900, and pelhaps until as late as the developm ent of

antibiotics in the 1940s, standard m odern techniques

such as dilation and cuiettage w ere not nearly so safe

as they are today. Thus it has been aigued that a state's real concern In enacting a crim

inal abortion law w

as to protect the pIegnant w

om an, that is, to iestrain he1

from subm

itting to a procedure that placed hel life in serious jeopaldy.

M odeln m

edical techniques have alteled this situ- a tio

n A

p p e lla

n ts a

n d va

rio u s a

m ict m

fe i to

m e d ica

l d a ta

ln d lc

a tln

ÿ th

a t a

b m

tm n in

ÿ n ilv

m o c rn

n n ÿ v th

n f

is, p rio

r to th

e e

n d o

f first tiim e ste

r, a lth

o u g h n

o t

w ithout its risk, is now

relatively safe. M oltahty rates

fo i w

o m

e n

u n

d e

ig o

m g

e a

rly a b

o itio

n s, w

h e

le th

e p

lo ce

d u

Ie is le

g a

l, a p

p e

a i to

b e

a s lo

w a

s o r lo

w e

r th

a n th

e la

te s fo

l n o lm

a l ch

lld b n th

. C o n se

q u e n tly,

any m teiest of the state in plotecting the w

om an fiom

a n

in h

e ie

n tly h

a za

id o

u s p

ro ce

d u

ie , e

xce p

t w h

e n

it w

o u ld

b e e

q u a lly d

a n g e ro

u s fo

r h e I to

fo rg

o it, h

a s

laigely dlsappeaied. O f C

O U

lS e, im

portant state intel- ests m

the alea of health and m edical standaids do

ie m

a ln

T h

e sta

te h

a s a

le g

itim a

te in

te re

st in se

e in

g to it that abortion, like any othei m

edical procedm e,

is p e rfo

lm e d u

n d e l cn

cu m

sta n ce

s th a t ln

su ie

m a xi-

m u

m sa

fe ty fo

r th e

p a

tie n

t T h

is in te

re st o

b vio

u sly

extends at least to the peiform ing physician and his

sta ff, to

th e

fa cilitie

s re vo

lve d

, to th

e a

va lla

b lh

ty o f

aftei-caxe, and to adequate plovision for any com ph-

cation ol em elgency that m

ight anse T he prevalence

o f h

ig h m

o lta

h ty

la te

s a

t ille g a l "a

b o itlo

n m

ills "

stIengthens, rather than w eakens, the state's interest

in ie

g u

la tln

g th

e co

n d

lh o

n s u

n d

e I w

h ich

a b

o itlo

n s

a ie

p e lfo

rm e d M

o re

o ve

l, th e risk to

th e w

o m

a n

lncleases as hei pregnancy continues T hus the state

le ta

m s a

d e fin

ite in

te re

st in p

ro te

ctin g th

e w

o m

a n 's

ow n health and safety w

hen an aboltion is pelform ed

at a late stage of pregnancy. T

h e

th ird

re a

so n

is th e

sta te

's ln te

le st--so

m e

phrase It in term s of duty--in protecting plenatal life

S om

e of the argum ent foi this justification 1 ests on the

th e

o ry th

a t a

n e

w h

u m

a n

life is p

re se

n t fro

m th

e m

om ent of conception T

he state's interest and gen- elal obhgatlon to plotect life then extends, it is argued, to plenatal hfe. O

nly w hen the life of the plegnant

m othei herself is at stake, balanced against the life

sh e ca

ru e s w

ith in

h e r, sh

o u ld

th e ln

tm e st o

f th e

e m

b ryo

O l fe

tu s n

o t p

re va

il L o g ica

lly, o f co

u ise

, a legitim

ate state intelest in this area need not stand or fall on acceptance of the belief that life begins at con- ce

p tio

n o

i a t so

m e o

th e r p

o in

t p u o r to

h ve

b ilth

. In assessing the state's lntelest, recognition m

ay be given to the less rigid clm

m that as long as at least potential

life is involved, the state m ay asselt intelests beyond

the plotecnon of the plegnant w om

an alone. P

altIes challenging state abortion law s have sharply

disputed in som e courts the contention that a purpose of

these law s, w

hen enacted, w as to piotect prenatal life.

P ointing to the absence of legislative history to suppolt

the contention, they claim that m

ost state law s w

eie designed solely to plotect the w

om an B

ecause m edical

advances have lessened this concern, at least w ith iespect

tÿ ÿ

I,c ,,t*,a

n m

,= ,a

, h J n

, o c rn

n n o ÿ th

o 'u

m a n o th

n t u

lflh

R O

E V

. W A

D E

377

iespect to such abortions the law s can no longel be jus-

tified by any state interest T heie ÿs som

e scholm ly sup-

p o

rt fo i th

is vie w

o f o

n g

in a

l p u

rp o

se T

h e

fe w

sta te

s co

re rs ca

lle d u

p o n to

m te

rp ie

t th e n la

w s in

th e la

te m

neteenth and eaily tw entieth centunes did focus on

the state's lnteiest in protecting the w om

an's health iathei than in preselw

ng the em bi2¢o and fetus..

T h e C

o n stitu

tio n d

o e s n

o t e

xp licitly m

e n tio

n a

n y

fight of privacy In a line of decisions, how evel, going

back peihaps as fax as U m

on P acific R

. C o. v. B

otsfotd (1891), the C

ourt has recognized that a nght of peisonal privacy, oi a gum

antee of celtaln axeas O l zones of pn-

vacy, does ernst under the C onstltuhon. In varying con-

texts the C oult or individual Justices have indeed found

at least the ioots of that vght in the F nst A

m endm

ent, . . . m

th e F

o u ith

a n d F

ifth A

m e n d m

e n ts, . . in

th e

penum blas of the B

all of R ights, . In the N

inth A

m endm

ent, . oi m the concept of hberty guaranteed

by the fiist section of the F ourteenth A

m endm

ent . T

hese decisions m ake It clem

that only pelsonal nghts that can be deem

ed "fundam ental" oi "im

plicit in the concept of oldeled llbelty" axe included in this guar- antee of personal privacy. T

hey also m ake it clear that

the nght has som e extension to activities relating to

m m

T ia

g e

, . p lo

c m

a tlo

n ,., c

o n

n a

c e

p tio

n , fa

m ily

relationships .... and child ieanng and education T

his iight of puvacy, w hether it be founded in the

F ouiteenth A

m endm

ent's concept of personal hbeity a

n d

le stn

ctlo n

s u p

o n

sta te

a ctio

n , a

s w e

fe e

l it a s,

o r, a

s th e

D istrict C

o ro

t d e

te im

ln e

d , in

th e

N in

th A

m e n d m

e n t's re

se iva

tlo n o

f rig h ts to

th e p

e o p le

, is b

ro a

d e

n o

u g

h to

e n

co m

p a

ss a w

o m

a n

's d e

cisio n

w hethel ol not to term

inate he1 plegnancy A

ppellants and som e am

tct argue that the w om

an's right is absolute and that she is entitled to telm

inate her pregnancy at w

hatevei tim e, m

w hatever w

ay, and fox w

hatevel reason she alone chooses. W ith this w

e do not agree. A

ppellants' argum ents that T

exas elthel h a s n

o va

lid in

te ie

st a t a

ll m ie

g u la

tln g th

e a

b o itio

n decision, or no lnteiest strong enough to suppoit any h m

ita tio

n u

p o n th

e w

o m

a n 's so

le d

e te

im in

a tlo

n , is

unpersuasive. T he C

ourt's decisions iecogm zing anght

of privacy also acknow ledge that som

e state regulation in axeas protected by that right is appropnate As noted above, a state m

ay propeily asselt lm poitant interests

in safeguaxding health, in m aintaining m

edical stan- dards, and in protecting potenhal life. A

t som e point

in pregnancy, these iespective interests becom e suffi-

rlo n

tl'u o

n rn

n o

llÿ n

o ÿ tn

q n

q tn

m ÿ

a c q

Iln tln

n o

f th e

fa c to

ls

378 R E

P R

O D

U C

T IO

N

that goveln the abortion decision The privacy fights involved, therefole, cannot be stud to be absolute .

W e

th e

re fo

re co

n clu

d e

th a

t th e

rig h

t o f p

e rso

n a

l p riva

cy in clu

d e s th

e a

b o ltlo

n d

e cisio

n , b

u t th

a t th

is right IS

not unquahfied and m ust be consldeled against

im poitant state lnteiests in iegulatlon W

e n

o te

th a

t th o

se fe

d e

ra l a

n d

sta te

co u

its th a

t have recently considered aboltlon law

challenges have reached the sam

e conclusion .. A

lthough the results are divided, m ost of these

courts have agreed that the right of privacy, how ever

based, is bload enough to cover the aboltion decision; that the right, nonetheless, is not absolute and is sub- je

ct to so

m e

lim ita

tio n

s; a n

d th

a t a

t so m

e p

o in

t th e

state interests as to protection of health, m edical stan-

dards, and prenatal hfe, becom e donnnant. W

e agree w

ith th

is a p

p lo

a ch

... T

he appellee and certain am ict algue that the fetus

IS a "person" w

ithin the language and m eaning of the

F o

u rte

e n

th A

m e

n d

m e

n t In

su p

p o

rt o f th

is th e

y o u

t- line at length and in detail the w

ell-know n facts of

fetal developm ent, ff this suggestion of personhood is

established, the appellant's case, of com se, collapses,

for the fetus's right to life is then gualanteed specifi- cally by the A

m endm

ent. The appellant conceded as m

uch on leargum ent. O

n the other hand, the appellee conceded on reargum

ent that no case could be cited that holds that a fetus is a person w

ithin the m eaning

of the F om

teenth A m

endm ent. . .

A ll this, together w

ith our observation, supra, that thloughout the m

ajol portion of the nineteenth century pievailing legal aboltIO

n practices w eie fro" freer than

they ale today, pelsuades us that the w old "peIson," as

used in the F ouiteenth A

m endm

ent, does not include the unborn .... Indeed, our decision in U

m ted S

tates v. ¼

utch (1971), lnfelentially is to the sam e effect, foi w

e theie w

ould not have indulged in statutoly interpretation favolable to abortion in specified circum

stances if the necessary consequence w

as the telm inatlon of life enti-

tled to F ouxteenth A

m endm

ent plotectlon .. A

s w e have intim

ated above, it is leasonable and appropriate for a state to decide that at som

e point in tim

e anothel intelest, that of health of the m other o1" that

of potentm l hum

an life, becom es significantly involved.

T he w

om an's privacy is no longer sole and any right of

privacy she possesses m ust be m

easuied accordingly. T

e xa

s u rg

e s th

a t, a

p a

rt fro m

th e

F o

u rte

e n

th A

m endm

ent, life begins at conception and is present throughout pregnancy, and that. therefore, the state

has a com pelling inteiest in protecting that life from

and after conception. W e need not resolve the difficult

question of w hen life begins W

hen those trained in th

e re

sp e

ctw e

d iscip

lin e

s o f m

e d

icin e

, p h

ilo so

p h

y, and theology ale unable to arrive at any consensus, the judiciary, at this point in the developm

ent of m an's

know ledge, is not In a position to speculate as to the

a n s w

e l.

It should be sufficient to note briefly the w ide diver-

gence of thinking on this m ost sensitive and difficult

question. T here has alw

ays been strong support for the view

that life does not begin until live bilth This w

as the belief of the S toics. It appears to be the pre-

dom inant, though not the unanim

ous, attitude of the Je

w ish

fa ith

. It m a

y b e

ta ke

n to

re p

le se

n t a

lso th

e posm

on of a large segm ent of the P

rotestant com m

u- m

ty, in so

fa r a

s th a t ca

n b

e a

sce rta

in e d , o

rg a n ize

d groups that have taken a form

al position on the abor- tion Issue have generally legarded abortion as a m

atter for the conscience of the Individual and her fam

ily. A s

w e have noted, the com

m on law

found greatel signif- Icance in quickening. P

hysicians and their scientific colleagues have regalded that event w

ith less Interest and have tended to focus either upon conception or upon live birth ol upon the interim

point at w hich the

fetus becom es "viable," that is, potentially able to live

outside the m other's w

om b, albeit w

ith artificial aid. V

iability is usually placed at about seven m onths (28

w eeks) but m

ay occur earliel, even at 24 w eeks. . .

In a

le a

s o th

e l th

a n

crim in

a l a

b o

rtio n

th e

la w

h a

s been reluctant to endorse any theory that life, as w

e lecognize it, begins befole live birth or to accold legal rights to the unboin except m

narrow ly defined situa-

tions and except w hen the rights are contingent upon

live b

n th

. . . In sh

o lt, th

e u

n b

o rn

h a

ve n

e ve

r b e

e n

recognized m the law

as pelsons m the w

hole sense. In view

of all this, w e do not agree that, by adopt-

ing one theoly of life, Texas m ay override the rights

of the pregnant w om

an that are at stake W e lepeat,

how evel, that the state does have an im

portant and le

g itim

a te

in te

re st m

p re

se rvin

g a

n d p

ro te

ctin g th

e health of the plegnant w

om an, w

hether she be a resi- dent of the state or a nonresident w

ho seeks m edical

consultation and tleatm ent there, and that it has stall

another lm poltant and legitim

ate interest In protect- ing the potentiality of hum

an life. T hese interests are

separate and distinct E ach grow

s in substantm hty as

th e

w o

m a

n a

p p

ro a

ch e

s te rm

a n

d , a

t a p

o in

t d u

rin g

plegnancy, each becom es "com

pelhng." W

ith lespect to the state's im portant and legitim

ate interest in the health of the m

other, the "com nellinÿ"

in the light of plesent m edical know

ledge, is at appioxim

ately the end of the filS t trim

ester This is so because of the now

established m edm

al fact . that u

n til th

e e

n d

o f th

e filst trim

e ste

l m o

ita lity in

a b

o r-

tio n is le

ss th a n m

o ita

lity m n

o lm

a l ch

ild b ilth

. It fo l-

lo w

s th a

t, fio m

a n

d a

fte l th

is p o

in t, a

sta te

m a

y regulate the abortion ploceduie to the extent that the regulation reasonably relates to the preservation and plotection of m

aternal health. E xam

ples of perm issi-

ble state regulation in this aiea are requirem ents as to

the qualifications of the pelson w ho is to perform

the aboitlon; as to the llcensule of that person; as to the fa

cility in w

h ich

th e p

m ce

d u ie

is to b

e p

e Ifo

rm e d ,

th a

t is, w h

e th

e r it m

u st b

e a

h o

sp ita

l o r m

a y b

e a

clinic or som e other place of less-than-hospital status;

as to the licensing of the facility; and the like. T

his m eans, on the othel hand, that, fol the peliod

o f p

re g n a n cy p

llO l to

th is "co

m p e lh

n g " p

o in

t, th e

attending phym clan, in consultation w

ith his patient, is flee to determ

ine, w ithout regulation by the state,

that in his m edical judgm

ent the patient's plegnancy should be term

inated. If that decision is reached, the judgm

ent m ay be effectuated by an abortion flee of

interference by the state. W

ith respect to the state's im portant and legitim

ate in

te re

st in p

o te

n tm

l life , th

e "co

m p e lh

n g " p

o in

t is a t

vlabihty. T his is so because the fetus then plesum

ably has the capabihty of m

eaningful life outside the m

other's w om

b S tate regulation piotective of fetal life

aftel vlaN hty thus has both logical and biological jus-

tifications. If the state IS interested in plotectlng fetal

life a

fte r vla

b d

ity, it m a

y g o

so fa

r a s to

p ro

scrib e

abortion during that period except w hen it is necessm

y to preserve the life ol health of the m

other... T

o sum m

arize and lepeat: 1 A

sta te

crim in

a l a

b o m

o n sta

tu te

o f th

e cu

n e n t

T exas type, that excepts from

crim inality only a hfe-

sa vin

g p

ro ce

d u

re o

n b

e h

a lf o

f th e

m o

th e

r, w ith

o u

t regald to pregnancy stage and w

ithout lecognitlon of th

e o

th e r in

te le

sts in vo

lve d , is vio

la tive

o f th

e D

u e

P rocess C

lause of the F ourteenth A

m endm

ent

(a) For the stage pnol to approxim ately the end of

the filst trim ester, the abortion decision and Its

effectuation m ust be left to the m

edical judgm ent

of the pregnant w om

an's attending physician. (b) FoI the stage subsequent to apploxim

ately the end of the first trim

ester, the state, m prom

oting its interest m

the health of the m otheI, m

ay, if it chooses, regulate the abortion plocedule in w

ays that are xeasonably 1elated to m

aternal health

R O

E V

. W A

D E

379

(c) F oi the stage subsequent to vm

blllty the state, m

p xo

m o tin

g its m

te ie

st m th

e p

o te

n tm

lity o f

h u

m a

n life

, m a

y, if it ch o

o se

s, ie g

u la

te , a

n d

even pioscnbe, abortion except w hele it is nec-

essary, in appiopnate m edical judgm

ent, for the preselvation of the life or health of the m

other

2 T

h e

sta te

m a

y d e

fin e

th e

te rm

"p h

yslcm n

" . . to

m e

a n

o n

ly a p

h ysicia

n cu

rre n

tly h ce

n se

d b

y th e

sta te

, a n d m

a y p

ro scilb

e a

n y a

b o ltio

n b

y a p

e rso

n w

ho is not a physician as so defined . T

h e d

e cisio

n le

a ve

s th e sta

te fle

e to

p la

ce in

cre a sin

g re

strictio n s o

n a

b o ltlo

n a

s th e p

e rio

d o

f plegnancy lengthens, so long as those lestnctlons ale tailored to the recognized state interests T

he decision vin

d ica

te s th

e rig

h t o

f th e p

h ysicia

n to

a d m

in iste

r m

edical treatm ent accoldlng to his plofesslonal judg-

m ent up to the points w

hele im portant state interests

provide com pelhng justlficahons for m

telventlon U p

to those points the abortion decision in all ItS aspects

is inherently, and prim arily, a m

edical decision, and basic 1 esponsIbillty for It m

ust lest w ith the physician

If an individual plactltionel abuses the privilege of exelclsing piopel m

edical judgm ent, the usual rem

e- dies, judicial and intraplofesslonal, m

e available...

JU S

TIC E

W H

ITE , w

ith w hom

JU S

TIC E

R E

H N

Q U

IS T

jo in

s, d isse

n tin

g

A t the heait of the contloversy in these cases are

those recurnng plegnancles that pose no dangel w hat-

soever to the hfe o1 health of the m other but m

e, nevel- theless, unw

anted fox any one or m ore of a variety of

re a so

n s---co

n ve

n ie

n ce

, fa rm

ly p la

n n in

g , e

co n o m

ics, & s-

hke of children, the em banassm

ent of illegitim acy, etc.

T he com

m on claim

before us is that for any one of such reasons, or fol no leason at all, and w

ithout asserting o1" claim

ing any threat to hfe O l health, any w

om an is enti-

tled to an abortion at he1 lequest if she is able to find a m

edical advisor w alling to undeltake the plocedure.

T he C

orot fol the m ost palt sustains this position:

D ulm

g the period prior to the tim e the fetus becom

es via

b le

, th e C

o n stitu

tio n o

f th e U

n ite

d S

ta te

s va lu

e s

th e co

n ve

n ie

n ce

, w h im

, o i ca

p rice

o f th

e p

u ta

tive m

othel m ore than the life oi potential life of the fetus,

the C onstitution, thelefole, guarantees the right to an

abortion as against any state law O

l policy seeking to p lo

te ct th

e fe

tu s fro

m a

n a

b o xtio

n n

o t p

ro m

p te

d b

y m

ole com pelling leasons of the m

othei.

W ith all due respect, I dissent I find nothing an the

language or history of the C onstitution to support the

C o u rt's ju

d g m

e n t T

h e C

o u rt sim

p ly fa

sh io

n s a

n d

a n n o u n ce

s a n

e w

co n stitu

tio n a l rig

h t fo

i p re

g n a n t

m others and, w

ith scaicely any leason oi authority foi its actm

n, invests that right w ith sufficient substance

to override m ost existing state abom

on statutes T he

upshot is that the people and the legislatuIes of the 5 0 sta

te s a

re co

n stitu

tio n a lly d

lse n title

d to

w e ig

h the ÿelative Im

poltance of the continued existence and developm

ent of the fetus, on the one hand, against a spectrum

of possible im pacts on the m

other, on the othei hand. A

s an exelcise of Iaw Judicial pow

er, the C

ourt perhaps has authority to do w hat it does today,

b u t in

m y vie

w ItS

ju d g m

e n t is a

n im

p lo

vid e n t a

n d

e xtra

va g

a n

t e xe

lclse o

f th e

p o

w e

r o f ju

d icia

l re vie

w that the C

onstÿtutm n extends to this C

ourt. T

h e

C o

u rt a

p p

a ie

n tly va

lu e

s th e

co n

ve n

ie n

ce o

f th

e p

re g

n a

n t m

o th

e l m

o xe

th a

n th

e co

n tin

u e

d e

xis- tence and developm

ent of the life or potential life that sh

e ca

iiie s. W

h e th

e r o

i n o t I m

ig h t a

g re

e w

ith th

a t

m alshaling of values, I can in no event join the C

ourt's judgm

ent because I find no constitutional w anant for

P L

A N

N E

D P

A R

E N

T H

O O

D

U nited S

tates S uprem

e C ourt, 1992

JU STIC

E O 'C

O N

N O

R , JU

STIC E KEN

N ED

Y, and JU

S TIC

E S

O U

TE R

announced the judgm ent of the

C ouit and dehveled the opinion of the C

ourt.

,,,,z,am g S

U C

h an order ot prlolltles on the people legislatures of the states. In a sensittve m

ea such as this, involving as it does issues oveI w

hich reasonable m

en m ay easily and heatedly differ, I cannot accept

th e C

o ro

t's e xe

Icise o

f its cle a r p

o w

e r o

f ch o ice

b y

interposing a constitutional bam er to state effoits to

protect hum an hfe and by investing m

otheis and doc- toIs w

ith the constitutionally piotected right to extei- m

inate it T his issue, foi the m

ost part, should be left w

ith th

e p

e o

p le

a n

d to

th e

p o

litica l p

ro ce

sse s th

e people have devised to govern their affaiis.

It is m y vie

w , th

e re

fo re

, th a

t th e

T e

xa s sta

tu te

is not constitutionally infirm

because it dem es aboitions

to th

o se

w h

o se

e k to

sto ve

o n

ly th e

ir co n

ve m

e n

ce rather than to piotect theiI life or health N

or IS this

plaintiff, w ho claim

s no thleat to her m ental or phys-

ical health, entitled to asseIt the possible rights of those w

om en w

hose pregnancy asseitedly im plicated

their health. T his, together w

ith U nited S

tates v V uitch,

402 U S

. 62 (1971), dictates revelsal of the judgm ent

of the D lsti'ict C

ourt.

E d

tto l 'ÿ n

o te

T h

e vo

te m

R o

e w

a s 7

-2 , w

ith Ju

stice s R

e h

n q

m st

and W hite dissenting

a p

a ie

n t's co

n se

n t. A

n o th

e i p

ro visio

n o

f'flIe A

ct leqm res that, unless ceitam

exceptions apply, a m

arried w om

an seeking an abom on m

ust sign a state- m

ent indicating that she has notified her husband of her m

tended abortion. T he A

ct exem pts com

pliance w

ith these three iequirem ents in the event of a "m

ed- ical em

m gency," w

hich is defined in § 3203 of the A

ct. In addition to the above provisions legulatang the p e ifo

lm a n ce

o f a

b o m

o n s, th

e A

ct im p o se

s ce rta

in reporting iequllem

ents on facilities that provide abor- tio

n se

lvlce s.

W e find it im

pelatlve to ievlew once m

oie the prin- ciples that define the ilghts of the w

om an and the

legm m

ate authoilty of the S tate respecting the telm

i- nation of pregnancies by abortion piocedures.

A fte

i co n sld

e lln

g th

e fu

n d a m

e n ta

l co n stitu

tio n a l

questions lesolved by R oe, piinclples of institutional

integrity, and the lule of stare dectsis, w e axe led to

conclude this: the essential holding of R oe v W

ade should be ietalned and once again reaffirm

ed It m

ust be stated at the outset and w ith clarity that

R oe's essential holding, the holding w

e reaffirm , has

th re

e p

a its. F

irst is a re

co g n itio

n o

f th e lig

h t o

f th e

w om

an to choose to have an aboltlO n before viabil-

ity a n d to

o b ta

in it w

ith o u t u

n d u e in

te ife

le n ce

fio m

th e

S ta

te B

e fo

re via

b ility, th

e S

ta te

's in te

re sts a

xe n

o t stio

n g

e n

o u

g h

to su

p p

o rt a

p ro

h ib

itio n

o f a

b o

l- tlon oi the im

position of a substantial obstacle to the w

o m

a n 's e

ffe ctive

lig h t to

e le

ct th e p

xo ce

d u le

. S

e co

n d

is a co

n fiim

a tlo

n o

f th e

S ta

te 's p

o w

e r to

le sh

ict a b

o ltio

n s a

fte r fe

ta l w

a b

ih ty, if th

e la

w co

n -

ta in

s e xce

p tio

n s fo

r p re

g n a n cie

s w h ich

e n d a n g e l a

w o m

a n 's life

o l h

e a lth

. A n d th

ird is th

e p

iln clp

le that the S

tate has legitim ate interests from

the outset of the piegnancy an protecting the health of the w

om an and the hfe of the fetus that m

ay becom e a

child. T hese principles do not contradict one anothei;

and w e adhm

e to each.

P LA

N N

E D

P A

R E

N TH

O O

D V

. C A

S E

Y 38I

v . C

A S

E Y

Iespondents as am tcus curiae, the U

nited S tates, as it

has done in five othei cases in the last decade, again a

s k s u

s to

o v e

n u

le R

o e

..

A t Issue m

these cases axe five pm w

sions of the P

ennsylvania A boltm

n C ontrol A

ct of 1982 as am

ended in 1988 and 1989. . . The A ct requires that

a w om

an seeking an abom on give her reform

ed con- sent pllO

l to the abom on plocedm

e, and specifies that sh

e b

e p

ro vid

e d

w ith

ce lta

in in

fo im

a tm

n a

t le a

st 24 hours befoie the aboition is peffoim

ed F ox a m

inoi to obtain an abortion, the A

ct lequiIes the inform ed con-

sent of one of heI pm ents, but pIow

des for a judicial bypass option if the m

Inoi does not w ish to or cannot

S hp O

pm m

n, D ocket N

o 91-744, 29 June 1992

II C

onstitutional protection of the w om

an's decision to term

inate her plegnancy deIIves from the D

ue P rocess

C lause of the F

ourteenth A m

endm ent. It declines that

n o S

ta te

sh a ll "d

e p llve

a n y p

e iso

n o

f life , h

b e lty, o

I pm

pelty, w ithout due plocess of law

" T he contIolhng

w o rd

in th

e ca

se b

e fo

le u

s is "h b e lty", . .

It a s a

p io

m lse

o f th

e C

o n

stitu tio

n th

a t th

e Ie

is a iealm

of personal liberty w hich the governm

ent m ay

n o

t e n

te r W

e h

a ve

vin d

ica te

d th

is p rin

cip le

b e

fo le

. M

am age is m

entioned now heie in the B

ill of R ights

I Liberty finds no lefuge In a JU

risprudence of doubt Y

et 19 years aftei O U

l holding that the C onstItuhon

protects a w om

an's light to term inate her pregnancy

in its early stages, R oe v W

ade, 410 U .S

. 113 (1973), that defim

tion of hberty as still questioned. Joining the

and lnteliacm l m

am age w

as illegal in m ost S

tates in the 19th century, but the C

ouit w as no doubt conect

in finding at to be an aspect of liberty piotected against state interference by the substantive com

ponent of the D

ue P rocess C

lause In G

I tsw old, w

e held that the C onstitution does not

peim lt a S

tate to folbld a m arried couple to use con-

traceptives. T hat sam

e freedom w

as latex gualanteed, undei the E

qual P rotection C

lause, foi unm arried cou-

ples. S ee E

tsenstadt v. B aird, 405 U

.S . 438 (1972)

C onstitutional protection w

as extended to the sale and distilbutm

n of contraceptives In C are), v P

opulation S

e rvice

s In te

rn a tio

n a l. It is se

ttle d n

o w

, a s it w

a s

w hen the C

ourt heard algum ents in R

oe v. W ade, that

th e C

o n stItu

tm n p

la ce

s h m

lts o n a

S ta

te 's lig

h t to

Interfere w ith a pelson's m

ost basic decisions about fam

ily and palenthood . T

h e

in e

sca p

a b

le fa

ct is th a

t a d

ju d

ica tio

n o

f su b

- stantlve due process claim

s m ay call upon the C

oult in m

telpretlng the C onstitution to exeiclse that sam

e capacity w

hich by tladltm n couits alw

ays have exel- clsed: leasoned judgm

ent Its boundalleS aie not sus-

ceptible of explesslon as a sim ple lule. T

hat does not m

e a n w

e a

re fle

e to

In va

lid a te

sta te

p o licy ch

o ice

s w

ith w hich w

e dlsagiee; yet neither does it pem alt us

to sh

rin k fio

m th

e d

u tie

s o f o

u i o

ffice ....

It sh o

u ld

b e

le co

g n

ize d

, m o

re o

ve r, th

a t in

so m

e critical lespects the aboltlO

n decision is of the sam e

chaiacter as the decision to use contraception, to w hich

G risw

o ld

v C o n n e cttcu

t, E tse

n sta

d t v B

a it&

a n d

C a re

y v. P o p u la

tto n S

e tvtce

s In te

rn a tio

n a l, a

ffo ld

constitutional piotectm n W

e have no doubt as to the correctness of those decisions. T

hey suppoit the iea- sonlng in R

oe relating to the w om

an's libeIty because they involve personal decisions concelnm

g not only the m

eaning of pm cleation but also hum

an respon- sib

ih ty a

n d ie

sp e ct fo

r It. A s w

ith a

b o m

o n , ÿe

a so

n -

a b

le p

e o

p le

w ill h

a ve

d lffe

le n

ce s o

f o p

in io

n a

b o

u t

these m atters O

ne view is based on such reveience

foi the w ondeÿ of cleation that any pregnancy ought

to b

e w

e lco

m e

d a

n d

ca m

e d

to fu

ll te lm

n o

m a

tte ÿ

how difficult it w

ill be to provide foi the child and ensuie its w

ell-being. A nother IS

that the inability to provide fol the nuitule and caIe of the infant is a C

lU -

elty to the child and an angm sh to the paient These

a ie

in tim

a te

vie w

s w ith

in fin

ite va

ria tio

n s, a

n d

th e

ll deep, personal charactel underlay oui decisions an G

ttsw old, E

tsenstadt, and C at ey. T

he sam e conceins

a re

p ÿe

se n

t w h

e le

th e

w o

m a

n co

n fro

n ts th

e ie

a h

ty

3ÿ2 R E

P R

O D

U C

T IO

N

that, perhaps despite hei attem pts to avoid it, she has

b e co

m e p

re g n a n t..

II1 . N

o e

vo lu

tio n

o f le

g a

l p rin

cip le

h a

s le ft R

o e

's d

o C

tlln a

l fo o

tin g

s w e

a ke

r th a

n th

e y w

e le

in 1

9 7

3 .

N o developm

ent of constitutional law since the case

w as decided has Im

plicitly oI explicitly left R oe

behind as a m ele survivor of obsolete constitutional

th a n kin

g . ..

T he R

oe C ourt itself placed its holding in the suc-

ce ssio

n o

f ca se

s m o st p

ro m

in e n tly e

xe m

p lifie

d b

y G

risw o ld

v. C o n n e cticu

t, se e R

o e , 4

1 0 U

.S , a

t 1 5 2 -1

5 3 W

h e n it IS

so se

e n , R

o e is cle

a rly in

n o

je o p a rd

y, sin ce

su b se

q u e n t co

n stitu

tio n a l d

e ve

lo p -

m ents have neither disturbed, nor do they threaten to

dirm nish, the scope of recognized protection accorded

to th

e llb

e lty le

la ta

n g to

in tim

a te

le la

tlo n sh

lp s, th

e fam

ily, and decisions about w hether O

l not to beget or b

e a

r a c

tn ld

...

[H ow

ever], tim e has oveltaken som

e of R oe's fac-

tu a l a

ssu m

p tio

n s a

d va

n ce

s m m

a te

rn a l h

e a lth

ca re

a llo

w fo

r a b

o rtio

n s sa

fe to

th e

m o

th e

l la te

r In p

le g

- nancy than w

as tiue in 1973, and advances in neona- tal care have advanced viability to a point som

ew hat

e a rlie

r . . B u t th

e se

fa cts g

o o

n ly to

th e sch

e m

e o

f tim

e lim its on the realization of com

peting lntelests, and the divergences from

the factual prem ises of 1973

have no beanng on the validity of R oe's central hold-

ing, that viability m arks the earliest point at w

hich the S

tate's interest in fetal life is constitutionally adequate to

ju stify a

le g

isla tive

b a

n o

n n

o n

th e

ra p

e u

tlc a b

o i-

txons T he soundness or unsoundness of that consti-

tu tio

n a

l ju d

g m

e n

t in n

o se

n se

tu in

s o n

w h

e th

e r

via b

ility o ccu

rs a t a

p p

ro xim

a te

ly 2 8

w e

e ks, a

s w a

s u su

a l a

t th e tim

e o

f R o e , a

t 2 3 to

2 4 w

e e ks, a

s it so

m e

tim e

s d o

e s to

d a

y, o r a

t so m

e m

o m

e n

t e ve

n shghtly eariler in plegnancy, as it m

ay if fetal respi- ia

to ly ca

p a

city ca n

so m

e h

o w

b e e

n h

a n

ce d

in th

e futule W

henever it m ay occm

, the attainm ent of via-

b llity m

a y co

n tin

u e to

se ive

a s th

e critica

l fa ct, ju

st as it has done since R

oe w as decided; w

hich is to say that no change m

R oe's factual underpinning has left

its ce n

tla l h

o ld

in g

o b

so le

te , a

n d

n o

n e

su p

p o

lts a n

argum ent for oven uhng it.. Libeity m

ust not be extinguished for w ant of a

lin e

th a

t is cle a

r A n

d it fa

lls to u

s to g

ive so

m e

re a

l

su b sta

n ce

to th

e w

o m

a n 's lib

e Ity to

d e te

im ln

e w

h e th

e r a

fte r n

e a rly 2

0 ye

a is o

f litig a tio

n in

R o e 's w

a ke

w e

to cm ry her pregnancy to full telm

. aie satisfied that the im

m ediate question is not the

W e co

n clu

d e th

e lin

e sh

o u ld

b e d

ra w

n a

t via b ility, so

u n d n e ss o

f R o e 's le

so lu

tio n o

f th e issu

e , b

u t th

e so that befoie that tim

e the w om

an has a right to ÿ! ÿ!ÿ;;ÿ p ie

ce d e n tia

l fo lce

th a t m

u st b

e a

cco id

e d to

its h o ld

- ch

o o

se to

te rm

in a

te h

e i p

re g

n a

n cy. W

e a

d h

e ie

to th

is in g

. A n

d w

e h

a ve

co n

clu d

e d

th a

t th e

e sse

n tia

l h o

ld in

g p rin

cip le

fo r tw

o re

a so

n s. F

iIst . is th e d

o ctlm

e o

f " 4 ÿ<

' o f R

o e

s h

o u

ld b

e re

a ffirm

e d

sta re

d e ctsts. A

n y ju

d icia

l a ct o

f lin e -d

ra w

in g m

a y :ÿJ Y

e t it m

u st b

e ie

m e m

b e re

d th

a t R

o e v. W

a d e sp

e a ks

se e m

so m

e w

h a t a

rb itia

ry, b u t R

o e w

a s a

re a so

n e d w

ith clm

ity m e

sta b lish

in g n

o t o

n ly th

e w

o m

a n 's h

b e rty

statem ent, elaboiated w

ith great care W e have tw

ice ieaffirm

ed It in the face of great opposition.. T

he second reason is that the concept of viability, a

s w e

n o

te d

in R

o e

, is th e

tim e

a t w

h ich

th e

re IS

a le

a listic p

o ssib

ility o f m

a in

ta in

in g a

n d n

o u rish

in g a

life outside the w om

b, so that the independent exis- tence of a second life can in xeason and all fairness be the object of state protection that now

ovem des the

rights of the w om

an. S ee R

oe, at 163 C onsistent w

ith other constitutional norm

s, legislatules m ay draw

lines w

hich appeai arbitrary w ithout the necessity of offer-

ing a justification. B ut C

O U

ltS m

ay not W e m

ust jus- tify the lanes w

e draw . A

nd there is no line other than via

b ility w

h ich

a s m

o re

w o

rka b

le T

o b

e su

re , a

s w e

have said, there m ay be som

e m edical developm

ents that affect the precise point of viability, but this is an im

precision w ithin tolerable hm

ats given that the m ed-

ical com m

unity and all those w ho m

ust apply its dis- co

ve rie

s w ill co

n tin

u e to

e xp

lo re

th e m

a tte

r T h e

via b

ility lin e

a lso

h a

s, a s a

p ra

ctica l m

a tte

r, a n

e le

- m

ent of fairness. In som e broad sense it m

ight be said that a w

om an w

ho falls to act before viability has con- se

n te

d to

th e S

ta te

's in te

rve n tm

n o

n b

e h a lf o

f th e

developing child T

h e

w o

m a

n 's rig

h t to

te rm

in a

te h

e l p

re g

n a

n cy

before vlablhty is the m ost central pnnciple of R

oe v. W

ade. It is a rule of law and a com

ponent of labeaty w

e ca

n n

o t re

n o

u n

ce .

O n the other side of the equation is the intelest of

the S tate an the protection of potential life The R

oe C

o m

a re

co g

n ize

d th

e S

ta te

's "im p

o rta

n t a

n d

le g

iti- m

ate interest in protecting the potentiality of hum an

life ." R

o e , a

t 1 6 2 . T

h e w

e ig

h t to

b e g

ive n th

is sta te

interest, not the strength of the w om

an's interest, w as

the difficult question faced in R oe. W

e do not need to say w

hether each of us, had w e been M

em beIs of the

C ourt w

hen the valuation of the S tate interest cam

e before it as an O

llginal m atter, w

ould have concluded, as the R

oe C ourt did, that its w

eight IS Insufficient to

justify a ban on abom ons prior to viability even w

hen at is subject to certain exceptions T

he m atter as not

before us In the first instance, and com ing as it does

PLANNED PARENTHO O

D V. CASEY 3ÿ3

but also the S tate's "im

poitant and legitim ate lnteiest

in p

o te

n tia

l life ." R

o e

, su p

ra , a

t 1 6

3 T

h a

t p o

itIo n

o f

the decision in R oe has been given too little acknow

l- edgem

ent and im plem

entation by the C oult in its sub-

se q u e n t ca

se s .

R o

e e

sta b

lish e

d a

trim e

ste r fra

m e

w o

lk to g

o ve

in aboltlon legulations U

nder this elabolate but rigid co

n stru

ct, a lm

o st n

o re

g u la

tio n a

t a ll is p

e rm

itte d

d u rin

g th

e first tilm

e ste

r o f p

re g n a n cy; re

g u la

tio n s

designed to protect the w om

an's health, but not to fua- ther the S

tate's interest in potential life, aIe perm itted

d u

rin g

th e

se co

n d

trim e

ste r, a

n d

d u

rin g

th e

th ird

m m

e ste

r, w h

e n

th e

fe tu

s is via b

le , p

ro h

lb m

o n

s a re

perm itted provided the life O

l health of the m othea as

n o t a

t sta ke

R o e v. W

a d e , a

t 1 6 3 -1

6 6 . M

o st o

f o m

cases since R oe have involved the application of roles

derived from the trim

ester fiam ew

ork T

he trlm esteÿ fram

ew oik no doubt w

as erected to ensure that the w

om an's right to choose not becom

e so

su b o rd

in a te

to th

e S

ta te

's m te

le st in

p ro

m o tin

g fe

ta l life

th a t h

e r ch

o ice

e xists m

th e o iy b

u t n

o t in

fa ct. W

e d

o n

o t a

g re

e , h

o w

e ve

r, th a t th

e trim

e ste

r approach is necessary to accom

plish this objective A fram

ew ork of this rigidity w

as unnecessaly and in its later interpretation som

etim es contradicted the S

tate's perm

issible exercise of its pow ers.

T hough the w

om an has a right to choose to telm

l- n

a te

o l co

n tin

u e

h e

l p re

g n

a n

cy b e

fo re

via b

ility, a t

does not at all follow that the S

tate is prohibited fiom taking steps to ensm

e that this choice is thoughtful a n d in

fo rm

e d E

ve n a

n th

e e

a rh

e st sta

g e s o

f p re

g -

n a n cy, th

e S

ta te

m a y e

n a ct ru

le s a

n d re

g u la

tio n s

designed to encourage her to know that thele ale philo-

sophic and social m gum

ents of great w eight that can

b e

b ro

u g

h t to

b e

a r in

fa vo

r o f co

n tin

u in

g th

e p

re g

- nancy to full term

and that there are piocedm es and

institutions to allow adoption of unw

anted chlldlen as w

ell as a certain deglee of state assistance if the m other

chooses to raise the child heiself. N

um erous form

s of state regulation m ight have the

incidental effect of lncaeasm g the cost or decleasm

g the avaIlabihty of m

edical care, w hethel for abortion

o i a

n y o

th e I m

e d ica

l p io

ce d u Ie

. T h e fa

ct th a t a

la w

w h ich

se rve

s a va

lid p

u ip

o se

, o n e n

o t d

e sig

n e d to

strike a

t th e rig

h t itse

lf, h a s th

e in

cid e n ta

l e ffe

ct o f

m aking it m

oie difficult oi m oie expensive to plocuie

a n a

b o ttio

n ca

n n o t b

e e

n o u g h to

in va

lid a te

it. O n ly

w hele state iegulatlon im

poses an undue bulden on a w

om an's ablhty to m

ake this decision does the pow ei

o f th

e S

ta te

ie a ch

in to

th e h

e a lt o

f th e lib

e rty p

ro -

tected by the D ue P

iocess C lause

T hese considerations of the natule of the aboitlon

right illustrate that at is an overstatem ent to descilbe

it a s a

rig h t to

d e cid

e w

h e th

e I to

h a ve

a n a

b o ltm

n "w

ith o

u t m

te lfe

ie n

c e

fro m

th e

S ta

te ," P

la n

n e

d P

arenthood of C entral M

o v D anforth, 428 U

S 52,

61 (1976) A ll aboitlon legulatlons anterfeie to som

e d e g L e e w

ith a

w o m

a n 's a

b ility to

d e cid

e w

h e th

e I to

term inate her piegnancy

R oe v. W

ade w as expless in its lecognltlO

n of the S

tate's "lm poltant and legitim

ate intelest[s] in preserv- ing and protecting the health of the pregnant w

om an

[and] an protecting the potentiality of hum an hfe." 410

U .S

, at 162. T he trlm

esteI fiam ew

olk, how ever, does

not fulfill R oe's ow

n plorm se that the S

tate has an inteI- est in protecting fetal life oa potential life. R

oe began the contladiction by using the trim

ester fram ew

ork to forbid any legulatlon of abortion designed to advance that inteaest befoae viability !d, at 163. B

efoae viabil- ity, R

oe and subsequent cases treat all governm ental

attem pts to Influence a w

om an's decision on behalf of

the potential life w ithin her as unw

m ianted T

his tleat- m

erit is, in our judgm ent, incom

patible w ith the iecog-

nation that there 1s a substantial state m teiest in potential

life thloughout pregnancy The very notion that the S

tate has a substantial interest in potential life leads to the conclusion that not all xegulations m

ust be deem ed unw

alranted. N ot

all burdens on the right to decade w hethex to team

inate a paegnancy w

all be undue. In our view , the undue

burden standard is the appiopnate m eans of reconcil-

in g th

e S

ta te

's m te

le st w

ith th

e w

o m

a n 's co

n stitu

-

tionally plotected liberty. A finding of an undue burden is a shorthand foa the

conclusion that a state regulation has the purpose O l

effect of placing a substantial obstacle in the path of a w

om an seeking an abortion of a nonviable fetus A

statute w ith this purpose is invalid because the m

eans chosen by the S

tate to further the interest m potentm

l life

m u st b

e ca

lcu la

te d to

ln fo

xm th

e w

o m

a n 's fle

e

ch o ice

, n o t h

ln d e i it .. T

h a t is to

b e e

xp e cte

d m

th e

application of any legal standaid w hich m

ust accom -

m o

d a

te life

's co m

p le

xity. W e

d o

n o

t e xp

e ct it to

b e

othelw lse w

ith lespect to the undue buiden standald W

e give this sum m

aly:

a w om

an m ay elect an aboltion, only to discover later, P

LA N

N E

D P

A R

E N

T H

O O

D v. C

A S

E Y

• n e se

p rin

ÿip lg

s c0 n tlo

l o u I a

sse ssm

e n t o

f th e

P ennsylvania statute, and w

e now tuin to the Issue ofN

>ÿ :ÿ w ith devastating psychological consequences, that her

the validity of ItS challenged pIO

V lS

lO ns.

:ÿ. d e

cisio n

w a

s n o

t fu lly in

fo lm

e d

. If th e

in fo

rm a

tio n

the S tate iequnes to be m

ade available to the w om

an V

is tlu

th fu

l a n

d n

o t m

is le

a d

in g

, th e

le q

u n

e m

e n

t m a

y

385

(a) To protect the cential right lecognxzed by R oe

v W ade w

hile at the sam e tim

e accom m

odat- in

g th

e S

ta te

's p ro

fo u

n d

ln te

ie st In

p o

te n

tia l

life , w

e w

ill e m

p lo

y th e u

n d u e b

u Id

e n a

n a ly-

sis a s e

xp la

in e d in

th is o

p in

io n A

n u

n d u e

buIden exists, and therefore a provision of law is In

va lid

, if its p u

rp o

se o

r e ffe

ct is to p

la ce

a su

b sta

n tia

l o b sta

cle In

th e p

a th

o f a

w o m

a n

se e kin

g a

n a

b o itio

n b

e fo

le th

e fe

tu s a

tta in

s viability

(b) W e reject the rigid tIim

ester flam ew

ork of R

oe v W ade T

o pIom ote the S

tate's pIofound m

teiest in potential life, throughout pIegnancy the S

tate m ay take m

easules to ensuie that the w

o m

a n

's ch o

ice is in

fo Im

e d

, a n

d m

e a

su ie

s d

e sig

n e

d to

a d

va n

ce th

is in te

re st w

ill n o

t b e

Invalidated as long as their purpose is to peI- su

a d e th

e w

o m

a n to

ch o o se

ch ild

b lith

o ve

i abortion T

hese m easules m

ust not be an undue burden on the right.

(c) A s w

ith any m edical pioceduie, the S

tate m ay

enact regulations to fuither the health or safety of a w

om an seeking an abortion U

nnecessaiy health regulations that have the puIpose or effect of presenting a substantial obstacle to a w

om an seeking an abortion Im

pose an undue buiden on the right.

(d) O ul adoption of the undue burden analysis

does not dlstulb the cential holding of R oe v

W ade, and w

e leaffiim that holding R

egaldless of w

hetheI exceptions aie m ade foi partlculai

cn cu

m sta

n ce

s, a S

ta te

m a

y n o

t p Io

h ib

it a n

y w

o m

a n

fro m

m a

kin g

th e

u ltim

a te

d e

cisio n

to term

inate her plegnancy befole viability. (e) W

e also reaffirm R

oe's holding that "subse- quent to viability, the S

tate in pIom oting its

intelest in the potentiality of hum an life m

ay, if it chooses, legulate, and even pIoscribe, abor- tion except w

here It is necessaly, in applopn- a

te m

e d

ica l ju

d g

m e

n t, fo

r th e

p Ie

se rva

tlo n

o f

the life O l health of the m

otheI." R oe i, W

ade, 410 U

.S ., at 164-165

The C orot of A

ppeals applied w hat it believed to be

the undue burden standaid and upheld each of the p

ro v is

m n

s e

x c e

p t fo

r th e

h u

s b

a n

d n

o tific

a tio

n requilem

ent. W e agree geneially w

ith this conclusion, b u t le

fin e th

e u

n d u e b

u ld

e n a

n a lysis in

a cco

id a n ce

w ith the principles aIticulated above

be peim lssible

W e also see no ieason w

hy the S tate m

ay not iequlie doctols to lnfolm

a w om

an seeking an aboltlO n of the

availability of m aterials relating to the consequences

to the fetus, even w hen those consequences have no

diiect IelatIon to her health A n exam

ple xllustIates the point W

e w ould think it constitutional fol the S

tate to requIIe that in oider foi there to be inform

ed consent to a kidney tlansplant opeIatlon the recipient m

ust be supplied w

ith inform ation about nsks to the donor as

w ell as iisks to him

self or helself W

hether the m andatory 24-hour w

aiting period is n

o n

e th

e le

ss in va

lid b

e ca

u se

in p

ra ctice

it is a su

b -

stantial obstacle to a w om

an's choice to term inate heI

piegnancy is a closm question. T

he findings of fact by th

e D

istllC t C

o u

lt in d

ica te

th a

t b e

ca u

se o

f th e

d is-

tances m any w

om en m

ust travel to leach an abortion provider, the practical effect w

ill often be a delay of m

u ch

m o

re th

a n

a d

a y b

e ca

u se

th e

w a

itin g

p e

rio d

IequlleS that a w

om an seeking an aboitlon m

ake at least tw

o visits to the doctol. T he D

lS tIlC

t C ouit also

fo u n d th

a t in

m a n y in

sta n ce

s th is w

ill ln cie

a se

th e

exposule of w om

en seeking aboltions to "the harass- m

ent and hostlhty of anti-abortion protestors dem on-

stlatlng outside a clinic" 744 F S upp, at 1351 A

s a iesult, the D

istrict C ouIt found that for those w

om en

w ho have the few

est financial Iesouices, those w ho

m ust travel long distances, and those w

ho have dif- ficu

lty e xp

la in

in g

th e

ir w h

m e

a b

o u

ts to h

u sb

a n

d s,

em ployels, or others, the 24-hour w

aiting period w ill

b e "p

a ltlcu

la rly b

u rd

e n so

m e "

W e a

re le

ft w ith

th e a

lg u m

e n t th

a t th

e va

rio u s

a sp

e cts o

f th e ln

fo im

e d co

n se

n t le

q u lie

m e n t a

re u

n co

n stitu

tio n

a l b

e ca

u se

th e

y p la

ce b

a rlle

is in th

e w

ay of aboltIO n on dem

and. E ven the broadest read-

ing of R oe, how

ever, has not suggested that thele is a co

n stitu

tio n a l rig

h t to

a b o rtio

n o

n d

e m

a n d . S

e e ,

e g., D oe v. B

olton, 410 U .S

, at 189 R ather, the right

pIotected by R oe is a right to decide to term

inate a p re

g n a n cy fre

e o

f u n d u e in

te rfe

re n ce

b y th

e S

ta te

. B

ecause the inform ed consent iequlrem

ent facilitates the w

ise exeicIse of that right it cannot be classified a s a

n In

te rfe

re n ce

w ith

th e fig

h t R

o e p

lo te

cts T h e

inform ed consent m

quliem ent is not an undue buiden

on that right.

B

W e next considei the ufform

ed consent iequnem ent 18

P a C

ons S tat. A

nn. § 3205 E xcept in a m

edical em er-

gency, the statute m quhes that at least 24 houis befoie

perforrm ng an abortion a physician inform

the w om

an of the nature of the pIoceduie, the health IIsks of the abortion and of childbirth, and the "probable gestational age of the unborn child." The physician oI a qualified nonphysician m

ust infoim the w

om an of the availabil-

ity of pnnted m aterials published by the S

tate describ- ing the fetus and providing Inform

ation about m edical

assistance for chIldbn-th, lnfoIm atlon about child sup-

poIt flora the fathei; and a list of agencies w hich pIo-

vid e a

d o p tm

n a

n d o

th e r se

ivIce s a

s a lte

In a tive

s to abortion A

n abortion m ay not be perfoIm

ed unless the w

om an ceitifies In w

riting that she has been lnfoIm ed

of the availablhty of these printed m aterials and has

been provided them if she chooses to w

ew them

. O

ui prior decisions establish that as w ith any m

ed- Ical plocedure, the S

tate m ay lequile a w

om an to give

h e

r w ritte

n In

fo rm

e d

co n

se n

t to a

n a

b o

ltio n

.. In A

b'on I, 462 U S

416 (1983), w e Invalidated an

oldinance w lnch requiied that a w

om an seeking an abol-

tion be provided by hei physician w ith specific infor-

m ation "designed to influence the w

om an's infoIm

ed choice betw

een abortion or cbA dbnth." Id., at 444. A

s w

e latel described the A kron I holding in T

hornburgh v. A

m ertcan C

ollege of O bstetrtctans and G

ynecologtsts, 476 U

.S ., at 762, them

w eie tw

o purpoited flaw s In the

A kion ordinance: the Inform

ation w as designed to dis-

suade the w om

an from haw

ng an abortion and the oIdi- nance Im

posed "a ngid Iequnelnent that a specific body of infolm

ation be given in all cases, nIespectlve of the pm

'tlculm needs of the patient . ." Ibid.

In attem pting to ensuie that a w

om an applehend

the full consequences of her decision, the S tate fur-

theIs the legitim ate purpose of Ieducing the risk that

S ection 3209 of P

ennsylvania's aboltlon law plovldes,

except in cases of m edical em

eigency, that no physi- cia

n sh

a ll p

e rfo

lm a

n a

b o ItlO

n o

n a

m a in

e d w

o m

a n

w ithout lecelvlng a signed statem

ent from the w

om an

that she has notified hel spouse that she is about to undergo an aboltlO

n T he w

om an has the option of pro-

vldlng an altelnative signed statem ent ceitifylng that

he1 husband is not the m an w

ho im pregnated hel, that

he1 husband could not be located; that the pregnancy is th

e ie

su lt o

f sp o u sa

l se xu

a l a

ssa u lt w

h ich

sh e h

a s

leported, or that the w om

an beheves that notifying hel husband w

ill cause him or som

eone else to inflict bodily injuly upon hel A

physician w ho perform

s an aboltlO n

on a m arIled w

om an w

ithout lecelvlng the appIopnate signed statem

ent w ill have his oi her license revoked,

and is hable to the husband fol dam ages . .

T he A

m m

Ican M edical A

ssociation (A M

A ) has

p u b lish

e d a

su m

m a Iy o

f th e ie

ce n t re

se a lch

in th

is fie

ld , w

h ich

in d ica

te s th

a t in

a n a

ve ra

g e 1

2 -m

o n th

p e rio

d in

th is co

u n try, a

p p io

xim a te

ly tw o m

illio n

w om

en are the victim s of seveie assaults by theil m

ale partnels In a 1985 suivey, w

om en repolted that neaily

one of eveiy eight husbands had assaulted then w ives

during the past year The A M

A view

s these figules as "m

arked underestim ates," because the natuie of these

in cid

e n ts d

Isco u la

g e s w

o m

e n fro

m le

p o ltin

g th

e m

, and because surveys typically exclude the very pooi, th

o se

w h o d

o n

o t sp

e a k E

n g lish

w e ll, a

n d w

o m

e n

w ho ale hom

eless or in institutions or hospitals w hen

the survey is conducted A ccording to the A

M A

, "[1]esealcheis on fam

ily violence aglee that the tlue In

cid e

n ce

o f p

a ltn

e l vio

le n

ce is p

lo b

a b

ly d o

u b

le th

e a

b o

ve e

stim a

te s; o

i fo u

l m illio

n se

ve le

ly a ssa

u lte

d w

om en per yeai. S

tudies suggest that flom one-fifth

to one-third of all w om

en w ill be physically assaulted

by a partneI or ex-partner during theli lifetim e" A

M A

C ouncil on S

cientific A ffalIS

, V iolence A

gainst W om

en 7 (1991) (em

phasis in original) Thus on an average d a y in

th e U

n ite

d S

ta te

s, n e a ily 1

1 ,0

0 0 w

o m

e n a

Ie se

ve le

ly a ssa

u lte

d b

y th e il m

a le

p a rtn

e ls M

a n y o

f these Incidents Involve sexual assault . . In fam

ilies w

here w ife-beating takes place, m

oleover, child abuse is

o fte

n p

re s e n t a

s w

e ll ....

In w

e ll-fu

n ctio

n in

g m

a irla

g e

s, sp o

u se

s d iscu

ss Im

poltant intim ate decisions such as w

hether to beai a

ch ild

. B u

t th e

Ie a

re m

illio n

s o f w

o m

e n

in th

is co

u n try w

h o a

ie th

e victim

s o f re

g u la

l p h ysica

l a n d

386 R E

P R

O D

U C

T IO

N

psychological abuse at the hands of theil husbands. S

hould these w om

en becom e plegnant, they m

ay have very good reasons foÿ not w

ishing to Inform then hus-

b a n d s o

f th e n d

e cisio

n to

o b ta

m a

n a

b o rtio

n . M

a n y

m ay have justifiable feals of physical abuse, but m

ay b

e n

o le

ss fe a

rfu l o

f th e

co n

se q

u e

n ce

s o f le

p o

rtm g

prior abuse to the C om

m onw

ealth of P ennsylvania.

M any m

ay have a leasonable feal that notifying their husbands w

ill plovoke turthet instances ofchtld abuse, these w

om en aIe not exem

pt from § 3209's nottfica-

ta o n te

q m

re m

e n t . . If a

n yth

in g m

th is fie

ld is ce

l- ta

m , it is th

a t victim

s o f sp

o u sa

l se xu

a l a

ssa u lt a

re extrem

ely reluctant to ieport the abuse to the govern- m

ent; hence, a gÿeat m any spousal 1ape victim

s w ill

n o t b

e e

xe m

p t flo

ra th

e n

o ttfica

tlo n le

q u a re

m e n t

im posed by § 3209. T

he spousal nottfication requu'em ent is thus likely to

plevent a slgm ficant num

ber of w om

en fiom obtaining

an aboltion. It does not m erely m

ake abortions a httle m

oÿe difficult ol expensive to obtain; for m any w

om en,

it w a ll ÿm

p o se

a su

b sta

n tia

l o b sta

cle W

e m

u st n

o t

bland ourselves to the fact that the slgm ficant num

ber of w

om en w

ho fear for then safety and the safety of their chH

dlen aie hkely to be detened from procm

m g

a n

a b

o rtio

n a

s su le

ly a s ff th

e C

o m

m o

n w

e a

lth h

a d

outlaw ed abom

on m all cases.

T his concluston ts in no w

ay inconsistent w ith our

decisions upholding parental notification o2 consent Ieqm

rem ents. T

hose enactm ents, and our judgm

ent

that they ate constitutional, aie based on the quite Iea- sonable assum

ptm n that m

inors w ill benefit fiom

con- sultation w

ith their patents and that chtldren w ill often

not ÿeahze that then parents have then best m teaests

at heart. W e cannot adopt a paIallel assum

phon about a

d u

lt w o

m e

n .

O ur cases estabhsh, and w

e reaffirm today, that a

S ta

te m

a y re

q m

re a

m m

o r se

e kin

g a

n a

b o a h o n to

obtain the consent of a pm ent or gum

dlan, provided that there ts an adequate judicm

l bypass procedm e.

U nder these paecedents, in our view

, the one-paient consent reqm

rem ent and judicial bypass procedure

a re

co n stitu

tio n a l .

387

V I

O ur C

onstitution is a covenant m nnm

g from the first

geneÿatm n of A

m ericans to us and then to future gen-

erations. It is a coherent succession E ach geneaation

m ust lealn anew

that the C onstttutton's w

ritten term s

em body ideas and aspnahons that m

ust survive m ore

a g e s th

a n o

n e . W

e a

cce p t o

u r re

sp o n sib

ility n o t to

reheat flora interpreting the full m eaning of the

covenant m light of all of our precedents W

e revoke it once agam

to define the freedom gum

anteed by the C

onstituhon's ow n prom

ise, the pxonuse of libelty...

E d

tto l's n

o te

C a

se y is a

p lu

ra h

ty d e

cisio n

, w h

ich m

e a

n s th

a t

th e

o p

in io

n issu

e d

b y Ju

stm e

s O 'C

o n

n o

l, K e

n n

e d

y, a n

d S

o u

te r w

a s

not supported in its totahty by a m ajority of the nine S

uplem e

C orot justices P

airs of the opm lon, how

eveL w ere each joined by

a t le

a st tw

o o

th e r ju

stice s, cre

a tin

g a

m a jo

rity o n th

o se

p in

ts

G O

N Z

A L

E S

v . C

A R

H A

R T

U nited S

tates S uprem

e C ourt, 2007

JU STIC

E KEN N

ED Y delivered the opm

ton of the C ourt

T hese cases requare us to consldea the validity of

the P artial-B

irth A bortion B

an A ct of 2003(A

ct), a fedelal statute aegulating abortion procedures.

A

T he A

ct proscribes a particular m anner of ending fetal

hfe, so ÿt is necessary hele, as st w as in S

tenberg [v. C

arhart, 530 U .S

. 914 (2000)] to discuss abom on

procedures in som e detail..

A bom

on m ethods vary depending to som

e extent on the preferences of the physicm

n and, of couise, on the term

of the plegnancy and the resulting stage of the unborn child's developm

ent B etw

een 85 and 90 percent of the approxim

ately 1 3 m illion abortm

ns perform

ed each year m the U

nited S tates take place

in the first three m onths of plegnancy, w

hich is to say in the first tfim

estea: . . T he A

ct does not aegulate these procedures

O f the rem

aining abom ons that take place each

year, m ost occur m

the second m m

estel T he surgical

procedure refened to as "dilatm n and evacuation" O

l "D

& E

" is the usual abom on m

ethod m this m

m ester.

A lthough individual techniques for perforrm

ng D &

E dlffea, the genexal steps ate the sam

e. . .

A fter sufficient dilatm

n the surgacal operation can com -

m ence. T

he w om

an is placed under genelal anesthesia or conscious sedation. T

he doctoa, often guided by u

ltra so

u n

d , in

se ÿts g

ra sp

in g

fo rce

p s th

ro u

g h

th e

w om

an's cervix and into the uterus to glab the fetus. The doctor grips a fetal part w

ith the forceps and pulls it back thiough the ceavax and vagina, contm

um g to

pull even after m eeting aesistance from

the cervix. T he

friction causes the fetus to tear apart. F or exam

ple, a leg m

ight be ripped off the fetus as it IS pulled through

the cervix and out of the w om

an. T he process of evac-

uating the fetus piece by piece continues until at has been com

pletely aem oved. A

doctol m ay m

ake 10 to 15 passes w

ith the folceps to evacuate the fetus m its

entfiety, though som etim

es aem oval as com

pleted w ith

few ea passes. O

nce the fetus has been evacuated, the p

la ce

n ta

a n

d a

n y le

m a

in ln

g fe

ta l m

a te

ria l a

ie su

c- tioned or sclaped out of the utelus T

he doctor exam -

lnes the different paits to ensure the entne fetal body h a s b

e e n a

e m

o ve

d . .

S o m

e d

o cto

rs, e sp

e cm

lly la te

l in th

e se

co n d tri-

m e

ste r, m

a y kill th

e fe

tu s a

d a

y o r tw

o b

e fo

le p

e r-

form ing the surgical evacuation. T

hey inject dlgoxln or potassium

chloride into the fetus, the um bihcal

cord, or the am niotic fluid. F

etal dem ise m

ay cause contractm

ns and m ake greater dilation possible. O

nce d e a d , m

o re

o ve

l, th e fe

tu s' b

o d y w

ill so fte

n , a

n d its

re m

o va

l w a

ll b e

e a

sie r. O

th e

r d o

cto rs le

fla in

fro m

injecting chem ical agents, believing at adds risk w

ith httle ol no m

edm al benefit

T he aboation plocedure that w

as the im petus foi the

num erous bans on "pm

tm l-blrth aboltlon," including

the A ct, is a vm

m taon of [the] standm

d D &

E . . F

ol discussion purposes this D

& E variation w ill be tefened

to as intact D &

E . T

he m ain dtffelence betw

een the tw

o procedm es as that in intact D

& E

a doctoI extracts the fetus intact or lm

gely intact . . T hele m

e no com -

plehenslve statistics lndlcatm g w

hat peacentage of all D

& E

s m e perfolm

ed in this m anner . .

In a

n in

ta ct D

& E

p ro

ce d

u re

th e

d o

cto r e

xtla cts

the fetus in a w ay conducive to pulling out its entne

In ta

ct D &

E g

a in

e d p

u b lic n

o to

lle ty w

h e n , in

1992, D r M

artin H askell gave a presentation desclib-

ln g h

is m e th

o d o

f p e lfo

lm ln

g th

e o

p e la

tlo n In

th e

usual Intact D &

E the fetus' head lodges in the ceI V

lX ,

and ddation is Insufficient to allow it to pass. H

askell explained the next step as follow

s

"'A t th

is p o

in t, th

e lig

h t-h

a n

d e

d su

rg e

o n

sh d

e s th

e fin

-

geIs of the left [hand] along the back of the fetus and hooks the shouldeis of the fetus w

ith the Index and iing fingeis (palm

dow n)

"'W h ile

m a ln

ta im

n g th

is te n sio

n , h

ftln g th

e ce

lvix a n d

applying tIactlon to the shouldeas w ith the fingels of the left

hand, the suIgeon takes a pan of blunt cuived M etzenbaum

scissois in the iight hand H e caIefully advances the tip,

cm red dow

n, along the spree and undel his m iddle tinge1

unnl he feels it contact the base of the skull under the tip of his m

iddle fingei "'[T]he suigeon then folces the scassois into the base of

the skull oi into the foiam en m

agnum H

aving safely enteaed the skull, he spIeads the scIssois to enlarge the opening

"'T h e su

Ig e o n ie

m o ve

s th e scisso

is a n d In

tIo d u ce

s a

suction catheter into this hole and evacuates the skull con- tents. W

ith the cathetel snll in place, he apphes naction to the fetus, Iem

ovm g it com

pletely flora the patient '" H R

R ep N

o. 108-58, p 3 (2003)

to allow the head to pass thlough" S

till othei physi- cians leach into the celvix w

ith theH foiceps and crush

the Ictus' skull. O thels continue to pull the fetus out

o f th

e w

o m

a n u

n til ÿt d

lsm ticu

la te

s a t th

e n

e ck, in

e ffe

ct d e ca

p ita

tin g it. T

h e se

d o cto

Is th e n g

la sp

th e

h e a d w

ith fo

lc e p s , c

lu s h it, a

n d Ie

m o v e It ....

D &

E and Intact D

& E

are not the only second_ trim

ester aboition m ethods D

octois also m ay abort a

fe tu

s th ro

u g h m

e d ica

l in d u ctio

n T

h e d

o cto

i m e d -

ica te

s th e

w o

m a

n to

in d

u ce

la b

o i, a

n d

co n

tIa ctio

n s

occm to dellvei the fetus Induction, w

hich unlike D &

E sh

o u ld

o ccu

r m a

h o sp

ita l, ca

n la

st a s little

a s

6 h

o u ls b

u t ca

n ta

ke lo

n g e l th

a n 4

8 It a

cco u n ts fo

r about five percent of second-tlim

estel abortions before 20 w

eeks of gestatm n and 15 pelcent of those aftei

2 0

w e

e ks. D

o cto

is tu rn

to tw

o o

th e

i m e

th o

d s o

f second-trim

estei aboition, hysterotom y and hystelec-

tom y, only m

em eigency situations because they carry

m cIeased risk of com

plications In a hysterotom y, as

in a caesarean section, the doctoi Iem oves the fetus

by m aking an recision through the abdom

en and uter- in

e w

a ll to

g a

in a

cce ss to

th e

u te

rin e

ca w

ty. A h

ys- teIectom

y Ieqm ÿes the rem

oval of the entne uterus. T

hese tw o piocedules lepresent about 07%

of second- trÿm

esteÿ abortions.

a n

a m

o re

re le

va n

r n e

re ,q

-rre ÿct ÿ lU

llg tlilg

ÿ

diffeIs fi'om that of the N

eblaska statute struck dow n

in S tenbetg. T

he opelatlve provisions of the A ct pro_

vide in relevant palt: II

"'D a H

askell w ent In w

ith foiceps and gi abbed the baby's

legs and pulled them dow

n Into the bnth canal T hen he

dehveled the baby's body and the aIIns--eveiything but the head The doctol kept the head Ilght Inside the uteius

"'T h e b

' aby s little fingeis w

exe clasping and unclasping, and his little feet w

ele kicking T hen the doctoi stuck the

SC lSSO

iS in the back of his head, and the baby's aim s jeiked

out, like a sim ile reactlon, like a flnIch, like a baby does

w hen he thinks he IS

going to fall "'T

h e d

o cto

i o p e n e d u

p th

e sclsso

ls, stu ck a

h ig

h -

pow ered suction tube Into the opening, and sucked the baby's

biam s out N

ow the baby w

ent com pletely lim

p . "'H

e cut the uInbxllcal coid and delIveled the placenta

H e threw

the baby In a pan, along w ith the placenta and the

Instium ents he had just used '" Ibtd

B A

fte l D

I H askell s procedure iecelved public attention,

w ith ensuing and increasing pubhc concern, bans on

"'paItlal birth abom on'" pm

lifelated B y the tim

e of the

S tenbetg declsm

n, about 30 S tates had enacted bans

designed to pIohibit the pIoceduie. In 1996, C ongless

also acted to ban pm tm

l-birth abom on. P

resident C linton

vetoed the congressional legislation, and the S enate

faded to ovem de the veto. C

ongiess approved another ball banning the procedure m

1997, but PiesIdent C linton

again vetoed it. In 2003, aftel this C ouit's decision m

S tenberg, C

ongress passed the A ct at Issue heie O

n N

ovem ber 5, 2003, PIesident Bush signed the Act Into

law . It w

as to take effect the follow ing day.

T he A

ct lesponded to S tenberg In tw

o w ays F

ilst, C

ongress m ade factual findings C

ongress detelrm ned

that this C ourt in S

tenberg "w as requiied to accept the

very questtonable findings Issued by the distlm t C

O U

lt judge," but that C

ongiess w as "not bound to accept the

sam e factual findings" C

ongiess found, am ong othei

things, that "[a] m oial, m

edical, and ethical consensus e xists th

a t th

e p

Ia ctice

o f p

e rfo

rm in

g a

p a rtia

l-b irth

abortion.., is a gruesom e and inhum

ane pIocedure that is nevel m

edically necessary and should be pIohibited."

D I. H

a ske

ll's a p

p ro

a ch

is n o

t th e

o n

ly m e

th o

d o

f killing the fetus once its head lodges m

the celvix, and "the process has evolved" since his presentation A

nothei doctol; foi exam ple, squeezes the skull aftei

"(a) A ny physician w

ho, In or affecting inteistate ol fol- eign com

m erce, know

ingly perfolm s a pam

al-bnth aboltlon and theieby kills a hum

an fetus shall be fined under this title o

r im p

liso n

e d

n o

t m o

Ie th

a n

2 ye

a ls, o

I b o

th T

h is su

b se

c- tion does not apply to a paltIal-birth abom

on that is neces- sary to save the hfe of a m

othei w hose hfe is endangeied

by a physical disolder, physical illness, ox physical injuiy, including a life-endangelIng physical condm

on caused by or raising fiom

the piegnancy itself This subsecnon takes effect 1 day after the enactm

ent "(b

) A s u

se d

In th

is se ctio

n --

"(1 ) th

e te

im 'p

a itia

l-b n th

a b o ltio

n ' m

e a n s a

n a

b o itio

n m

w h

ich th

e p

e xso

n p

e ffo

im in

g th

e a

b o

xtio n

-- "(A

) dehbeiately and Intennonally vaginally dehveIs a livin

g fe

tu s u

n til, in

th e ca

se o

f a h

e a d -first p

ie se

n ta

n o n ,

the entiie fetal head IS outside the body of the m

othei, or, in the case of bxeech plesentanon, any part of the fetal hunk past the navel is outside the body of the m

othel, foi the pur- pose of peffoxm

Ing an oveit act that the peison know s w

ill kill the paltm

lly delivered hying fetus, and "(B

) perform s the overt act, othei than com

pletion of delivery, that kills the paitIally delIveied hying fetus, and

"(2 ) th

e te

im 'p

h ysicia

n ' m

e a

n s a

d o

cto i o

f m e

d icin

e O

l osteopathy legally authoiIzed to piactIce m

edicine and surgery by the S

tate in w hich the doctoi peifoim

s such activity, or any othei individual legally authorized by the S

tate to perform abom

ons P lovtded, how

evel, T hat any

individual w ho IS

not a physician oi not othexw ise legally

authorized by the S tate to peifoIm

aboinons, but w ho nev-

eitheless directly peifolm s a pattlal-birth abortion, shall be

subject to the pxovlslons of this section "(d)(1) A

defendant accused of an oH 'ense undei this

section m ay seek a heaiing befoie the S

tate M edical B

oaid on w

hetheI the physician's conduct w as necessm

y to save the hfe of the m

othex w hose life w

as endangeied by a phys- ical disoidel, physical Illness, ol physical injury, including a hfe-endangeIIng physical condition caused by ol arising flora the piegnancy itself

"(2) T he findings on that issue aie adm

issible on that issue at the tilal of the defendant U

pon a m otion of the

defendant, the couit shall delay the beginning of the tirol fox not m

oie than 30 days to pexm it such a healing to take

place"(e ) A

w o m

a n u

p o n w

h o m

a p

a ttia

l-b irth

a b o itio

n is p

e i-

form ed m

ay not be prosecuted undel this secnon, fol a con- spiracy to violate this section, oI foi an offense undei section 2 , 3

, o i 4

o f th

is title b

a se

d o

n a

vio la

tio n o

f th is se

ctio n "

18U S

C § 1531 (2000ed.,S

upp IV )

T his is an abortion doctor's chm

cal description H ele

s another description from a nuise w

ho w itnessed the

sam e m

ethod peffotm ed on a 261/2-w

eek fetus and w

ho testified befoie the S enate Judiclm

y C om

m ittee

C ase3, involved a challenge to R

oe v W ade, 410 U

.S .

113 (1973) . W

e a

ssu m

e th

e fo

llo w

in g p

rin cip

le s fo

r th e p

u i-

p o se

s o f th

is o p in

io n . B

e fo

ie via

b ility, a

S ta

te "m

a y

n o t p

ro h ib

it a n y w

o m

a n fro

m m

a kin

g th

e u

ltim a te

decision to term inate hei pregnancy" 505 U

.S , at 879

(plm ahty opinion). It also m

ay not im pose upon this

right an undue buIden, w hich exists If a legulation's

"purpose oI effect is to place a substantial obstacle in the path of a w

om an seeking an aboltlO

n befoie the fetus attains vlablhty" Id., at 878. O

n the other hand, "[r]egulations w

hich do no m oÿe than m

eate a struc- tuial m

echanism by w

hich the S tate, or the parent oi

g u a rd

m n o

f a m

in o r, m

a y e

xp ie

ss p ro

fo u n d re

sp e ct

fol the life of the unborn are peim ltted, if they m

e not a substantial obstacle to the w

om an's exercise of the

right to choose" Id, at 877. C asey, in short, S

tluck a balance. T

he balance w as central to its holding W

e now

apply its standard to the cases at bai

[E dttor's note" P

ortions of the opinion have been om it-

ted here. T he court concludes that the A

ct is not con- stltutionally void for vagueness and that the statutory te

xt o f th

e A

ct sp e

cifyin g

ie stiictIo

n s o

n se

co n

d trim

ester abortions does not im pose an undue burden

because it only applies to intact D &

E , and does not

piohiblt a D &

E procedure w

heie the fetus is rem oved

"in p

a rts

."]

IV U

ndel the pnnclples accepted as contiolhng heie, the A

ct, a s w

e h

a ve

in te

ip ie

te d

it, w o

u ld

b e

u n

co n

stitu -

n o

n a

l "if its p u

rp o

se O

l e ffe

ct is to p

la ce

a su

b sta

n -

tia l o

b sta

cle in

th e p

a th

o f a

w o m

a n se

e kin

g a

n a

b o

rtio n

b e

fo re

th e

fe tu

s a tta

in s via

b lh

ty" C a

se y,

505 U S

, at 878 (pluiahty oplm on). T

he abortions affected by the A

ct's Iegulations take place both pie- viablhty and postviablhty, so the quoted language a

n d

th e

u n

d u

e b

u rd

e n

a n

a lysis it ÿe

lie s u

p o

n m

e a p p h ca

b le

. T h e q

u e stio

n is w

h e th

e i th

e A

ct, m e a -

suIed by its text In this facial attack, im poses a sub-

s ta

n tIa

l o b

s ta

c le

to la

te -te

ÿ m

, b u

t p ie

v la

b lllty

,

abO ltlons T

he A ct does not oll Its face im

pose a sub- sta

n tia

l o b

sta cle

, a n

d w

e re

je ct th

is fu rth

e r fa

cia l

challenge to its validity

A

T he A

ct's purposes aIe set folth In recitals pleceding Its o

p e

la tw

e p

lo vislo

n s. A

d e

scn p

tlo n

o f th

e p

ro h

ib -

Ited aboltion ploceduIe dem onstlates the Iattonale for

th e co

n g re

ssio n a l e

n a ctm

e n t T

h e A

ct p ro

scrib e s a

m ethod of aboltlon m

w hich a fetus as killed just

in ch

e s b

e fo

le co

m p

le tio

n o

f th e

b ilth

p ro

ce ss C

o n

- gress stated as follow

s "Im plicitly appioving such a

b ru

ta l a

n d

In h

u m

a n

e p

ro ce

d u

re b

y ch o

o sin

g n

o t to

p lo

h Ib

it it w ill fu

lth e i co

a Ise

n so

cie ty to

th e h

u m

a n -

lty of not only new borns, but all vulnelable and inno-

cent hum an life, m

aking it ancleaslngly difficult to protect such life" C

onglesslonal Findings (14)(N ), in

notes follow ing 18 U

.S .C

. § 1531 (2000 ed., S upp.

IV ), p. 769. The A

ct explesses iespect for the dignity of hum

an life.

C o

n g

ie ss w

a s co

n ce

rn e

d , fu

rth e

rm m

e , w

ith th

e effects on the m

edm al com

m unity and on its leputa-

tto n

ca u

se d

b y th

e p

Ia ctice

o f p

a rtia

l-b lIth

a b

o rtio

n The findings in the A

ct explain "P

a ttla

l-b n th

a b o m

o n co

n fu

se s th

e m

e d tca

l, le g a l,

and ethical duties of physm m

ns to pm sm

ve and prom ote

hfe, as the physlcm n acts duectly against the physm

al life of a chdd, w

hom he ol she had just dehvered, all but the

head, out of the w om

b, m m

dm to end that hfe" C

on- gressm

nal Findings (14)(J), lbld

T heie can be no doubt the governm

ent "has an m tei-

est m protecting the Integrity and ethics of the m

ed- ical w

ofession." W ashington v. G

lucksberg, 521 U S

702, 7311997); see also. U nder our pIecedents it is

cleat the S tate has a significant role to play in Iegu-

lating the m edical pIofession

C asey Ieaffirm

ed these goveInm ental objectives.

T he govelnm

ent m ay use its voice and its Iegulatoty

a u th

o lity to

sh o w

ItS p

ro fo

u n d re

sp e ct fo

r th e life

w ith

in th

e w

o m

a n A

ce n tra

l p re

m ise

o f th

e o

p in

io n

w as that the C

orot's precedents aftei R oe had "under-

value[d] the S tate's Inteiest in potential life." T

he plu- tahty opinion in&

cated "[tJhe fact that a law w

hich seives a valid purpose, one not designed to strike at the right itself, has the incidental effect of m

aking it m

o ie

d ifficu

lt o i m

o le

e xp

e n sive

to p

Io cu

ie a

n a

b o r-

hon cannot be enough to m vahdate it." T

his w as not

...... ÿ . lira

m trc

t p re

m is

e , th

a t th

e S

ta te

, flo ra

inception of the pIegnancy, m aintains its ow

n m gula-

toiy m teiest in protecting the hfe of the fetus that m

ay becom

e a child, cannot be set at naught by inteIpret. In

g C

a se

y's Ie q u ire

m e n t o

f a h

e a lth

e xce

p tio

n so

it becom

es tantam ount to allow

ing a doctoI to choose the abortion m

ethod he or she m ight prefeI W

here tt has a rational basis to act, and it does not tm

pose an undue burden, the S

tate m ay use ItS

regulatoiy pow er

to baI ceitam proceduies and substitute otheis, all in

fui therance of its legitim ate Inteiests m

I egulating the m

e d

m a

l p ro

fe ssio

n in

o Id

e r to

p io

m o

te re

sp e

ct fo r

hfe, m cluding hfe of the unborn.

T h

e A

ct's b a

n o

n a

b o

rtio n

s th a

t In vo

lve p

a rtia

l d

e h

ve ry o

f a h

vm g

fe tu

s fm th

e rs th

e G

o ve

rn m

e n

t's objectives N

o one w ould dispute that, for m

any, D &

E ts a pIoceduie itself laden w

ith the pow er to devalue

hum an hfe C

ongiess could nonetheless conclude that the type of aboition proscribed by the A

ct requires specific Iegulation because it im

phcates additional ethical and m

oral concerns that justify a special pio- hibltion. C

ongress deteIm lned that the abortion m

eth- ods it prosciibed had a "disturbing sim

ilarity to the kdling of a new

born infant," C ongressional F

indings (14)(L), in notes follow

ing 18 U S C

§ 1531 (2000 ed., S

upp IV ), p 769, and thus It w

as conceined w ith

"draw [ing] a bright hne that clearly distinguishes

a b

o rtio

n a

n d

In fa

n tm

id e

." C o

n g

re ssio

n a

l F in

d in

g s

(14)(G ), tbtd The C

ourt has in the past confirm ed the

validity of di aw ing boundaiies to prevent cet tam

prac- tices that extinguish life and aie close to actions that a

le co

n d

e m

n e

d . G

h m

ksb e

rg fo

u n

d re

a so

n a

b le

th e

S tate's "fear that perm

itting assisted suicide w ill strut

It dow n the path to voluntaiy and peIhaps even invol-

untary euthanasia" 521 U .S

., at 732-735

R e sp

e ct fo

r h u m

a n life

fin d s a

n u

ltim a te

e xp

re s-

sion in the bond of love the m other has for hei child.

T he A

ct iecognizes this reality as w ell W

hether to have an abortion requnes a difficult and painful m

oral d

e cisio

n W

h ile

w e

fin d

n o

Ie h

a b

le d

a ta

to m

e a

sm e

the phenom enon, It seem

s unexceptionable to con- clu

d e so

m e w

o m

e n co

m e to

re g ie

t th e ir ch

o ice

to aboit the Infant life they once created and sustained. S

eveie depiession and loss of esteem can follow

In a

d e

cisio n

so /'ta

u g

h t w

ith e

m o

tio n

a l co

n se

- quence som

e doctois m ay pIefer not to disclose pie-

cise details of the m eans that w

ÿll be used, confinm g

th e m

se lve

s to th

e le

q u ire

d sta

te m

e n t o

f llsks th e

p lo

ce d u re

e n ta

ils. F ro

m o

n e sta

n d p o in

t th is o

u g h t

n o t to

b e su

rp n sin

g . A

n y n

u m

b e i o

f p a tte

n ts fa

cin g

ear all details, lest the usual anxiety preceding inva- sire

m e

d ica

l p io

ce d

u re

s b e

co m

e th

e m

o re

in te

n se

. This is likely the case w

ith the abortion procedures here in issue.

It is, h o w

e ve

r, p ie

cise ly th

is la ck o

f in fo

im a tio

n concerm

ng the w ay in w

hich the fetus w ill be killed

that is of legitim ate concern to the S

tate The S tate

has an interest in ensuring so grave a choice is w ell

infoim ed It is self-evident that a m

other w ho com

es to regret her choice to abort m

ust struggle w ith grief

m oIe anguished and sorrow

m oIe profound w

hen she le

a in

s, o n ly a

fte i th

e e

ve n t, w

h a t sh

e o

n ce

d id

n o t

kn o

w . th

a t sh

e a

llo w

e d

a d

o cto

r to p

ie rce

th e

sku ll

and vacuum the fast-developing brain of her unboin

child, a child assum ing the hum

an form .

It is a reasonable infeience that a necessary effect of the legulation and the know

ledge it conveys w ill be

to encourage som e w

om en to caw

y the infant to full term

, thus reducing the absolute num ber of late-term

abortions. T he m

edical profession, furtherm oIe, m

ay find diffeIent and less shocking m

ethods to aboit the fetus in the second trIm

estm , theleby accom

m odating

legislative dem and T

he S tate's lnteiest m

respect for life is advanced by the dialogue that better inform

s th

e p

o litica

l a n d le

g a l syste

m s, th

e m

e d m

a l p

ro fe

s- sion, expectant m

others, and society as a w hole of the

consequences that follow from

a decision to elect a late-term

abortion. It is objected that the standard D

& E

is in som e

iespects as brutal, if not m oIe, than the intact D

& E

, so that the legislation accom

plishes little. W hat w

e have alleady said, how

ever, show s am

ple justification foI the legulatlon. P

altial-birth abortion, as defined by the A

ct, differs fiom a standard D

& E

because the foim

er occurs w hen the fetus is partially outside the

m o

th e

i to th

e p

o in

t o f o

n e

o f th

e A

ct's a n

a to

m ica

l la

n d m

a rks. It w

a s re

a so

n a b le

fo r C

o n g re

ss to th

in k

that paltial-birth abortion, m ore than standard D

& E

, "underm

ines the public's perception of the appropri- ate role of a physm

m n during the dehvery process,

and peIverts a process during w hich life is bIought

Into the w orld." C

ongressional Findings (14)(K ), In

notes follow ing 18 U

S .C

. § 1531 (2000 ed, S upp.

IV ), p 769. T

hele w ould be a flaw

in this C oult's

logic, and an Irony in its jurisprudence, w eIe w

e filst to conclude a ban on both D

& E

and intact D &

E w

a s o

ve ib

ro a d a

n d th

e n to

sa y it is in

a tlo

n a l to

b a n

only intact D &

E because that does not proscribe

both procedures In sum , w

e reject the contention that the congressional purpose of the A

ct w as "to place a

substantial obstacle m the path of a w

om an seeking

an abortion" 505 U S

, at 878, 112 S C

t 2791 (plu- ia

lity o p

in io

n ).

T he A

ct's fuitherance of legitim ate governm

ent inter- ests bern s upon, but does not iesolve, the next question: w

hethel the A ct has the effect of im

posing an uncon- stitutional buIden on the aboltlO

n right because it does n

o t a

llo w

u s e

o f th

e b

a iie

d p

ro c e

d u

re w

h e

re "'n

e ce

ssa iy, in

a p

p io

p rla

te m

e d

ica l ju

d g

m e

n t, fo

r [th

e ] p

ie se

rva tio

n o

f th e . . . h

e a lth

o f th

e m

o th

e i.'"

A yotte, 546 U

.S ., at 327-328 (quoting C

asey). The prohibition in the A

ct w ould be unconstitutional, under

p re

ce d

e n

ts w e

h e

re a

ssu m

e to

b e

co n

tro llin

g , if it

"subject[ed] [w om

en] to significant health risks" A

yotte at 328, see also C asey at 880 (opinion of the

C orot) In A

yotte the parties agreed a health exception to the challenged parental-Involvem

ent statute w as

n e

ce ssa

ry "to a

ve rt se

lio u s a

n d o

fte n irre

ve rsib

le dam

age to [a plegnant m inor's] health." 546 U

.S ., at

328. H eie, by contrast, w

hether the A ct creates sig-

nificant health nsks for w om

en has been a contested factual question. T

he evidence presented in the tnal C

O U

ltS and before C

ongless dem onstrates both sides

have m edical suppoit foI their positron

T he question becom

es w hether the A

ct can stand w hen

th is m

e d

ica l u

n ce

lta in

ty p e

isIsts . . M

e d ica

l u n ce

lta in

ty d o e s n

o t fo

Ie clo

se th

e e

xe r-

cise of legislative pow er m

the abom on context any

m ore than it does in other contexts T

he m edical uncer-

tainty ovei w hether the A

ct's piohibltion cIeates sig- nificant health lisks plovides a sufficient basis to conclude in this facial attack that the A

ct does not im

pose an undue burden. T

h e co

n clu

sio n th

a t th

e A

ct d o e s n

o t Im

p o se

a n

undue burden as supported by othei consldeiatlons. A

lte rn

a tive

s a re

a va

ila b

le to

th e

p ro

h ib

ite d

p io

ce -

d u

re A

s w e

h a

ve n

o te

d , th

e A

ct d o

e s n

o t p

io sciib

e D

& E

. . . In a

d d

itio n

th e

A ct's p

ro h

ib itio

n o

n ly

applies to the delivery of "a living fetus." If the intact D

& E

proceduIe is tIuly necessary in som e circum

- stances, it appeais likely an injection that kills the fe

tu s IS

a n a

lte rn

a tive

u n d e I th

e A

ct th a t a

llo w

s th e

doctor to perfolm the piocedure

392 R EPR

O D

U C

TIO N

In leaching the conclusion the A ct does not requne

a health exception w e leject celtam

aigum ents m

ade by the proxies on both sides of these cases O

n the one hand, the A

ttorney G eneral urges us to uphold the A

ct o

n th

e b

a sis o

f th e

co n

g re

ssio n

a l fin

d in

g s a

lo n

e A

lthough w e review

congressional factfindlng under a deferential standald, w

e do not in the c11cum stances

here place dlsposltlV e w

eight on C ongress' findings.

T he C

ourt retains an independent constitutional duty to leview

factual findings w here constitutional rights

a re

a t sta

k e

..

A s respondents have noted, and the D

istrict C ourts

recogm zed, som

e lecltations m the A

ct ale factually incon'ect W

hethel or not accurate at the tim e, som

e of th

e Im

p o rta

n t fin

d in

g s h

a ve

b e e n su

p e rse

d e d ...

C o n g ie

ss d e te

rm in

e d n

o m

e d ica

l sch o o ls p

ro vid

e instruction on the plohlbited procedule. T

he testim ony

in th

e D

istrict C o u lts, h

o w

e ve

r, d e m

o n stla

te d in

ta ct

D &

E is ta

u g h t a

t m e d ica

l sch o o ls. C

o n g re

ss a lso

found thele existed a m edical consensus that the pro-

hlblted plocedm e is never m

edically necessaxy. T he

evidence plesented in the D istrict C

outts conttadicts that conclusion. U

ncritical defelence to C ongress' fac-

tual findings In these cases is Inappropriate O

n the other hand, ielym g on the C

orot's opim on

in S tenberg, respondents contend that an abom

on reg- ulation m

ust contain a health exception "if 'substantm l

m edical authority supports the proposition that ban-

ning a paitlculax w oceduie could endanger w

om en's

health.'" B rief fol R

espondents m N

o. 05-380, p. 19 (quoting 530 U

S ., at 938, 120 S

.C t 2597); see also

B rie

f fo r R

e sp

o n d e n t P

la n n e d P

a re

n th

o o d e

t a l. in

N o. 05-1382, at 12 (sam

e). A s Illustrated by respon-

dents' argum ents and the decisions of the C

om ts of

A ppeals, S

tenbetg has been Interpreted to leave no m

argin of erroi fox leglslatuxes to act an the face of m

edical unceltam ty.

A ze

ro to

le ra

n ce

p o

h cy w

o u

ld strike

d o

w n

le g

m -

m a

te a

b o

ih o

n le

g u

la tlo

n s, like

th e

p le

se n t o

n e

, If som

e part of the m edical com

m unity w

ele dlsinchned to follow

the proscriptm n T

his is too exacting a stan- dard to im

pose on the legislative pow ei, exelcised in

this Instance under the C om

m elce C

lause, to legulate the m

edical professm n. C

onsiderations of m arginal

safety, including the balance of risks, are w ithin the

legislative com petence w

hen the iegulation is rational and in pm

sm t of legitim

ate ends. W hen standard m

ed- real options are available, m

ele convenience does not £

1 1

ffie e

ÿ tn

d iÿ

n ln

o o

th o

rn n

n d

if ÿ n

rn o

n ,',ÿ

o ÿ A

,,r,ÿ o

h ÿ ,,o

different risks than othels, it does not follow that the

S tate is altogether barred fiom

im posing reasonable reg,

ulatlons. T he A

ct is not invalid on its face w hele there

s u n ce

rta in

ty o ve

r w h e th

e r th

e b

a n e d p

io ce

d u re

is ever necessary to preserve a w

om an's health, given

the availabihty of othei abortion procedutes that are considered to be safe alternatives

It is so ordered.

JUSTICE G INSBURG

, W ITH W

HO M

JUSTICE STEVEN

S, JU STIC

E SO U

TER , AN

D JU

STIC E

B R

E Y

E R

JO IN

, D IS

S E

N TIN

G

T oday's decision is alarm

ing. It refuses to take C asey

and S tenberg seriously. It tolelates, indeed applauds,

fedel al Intervention to ban nationw ide a procedm

e found necessary and proper in certain cases by the A

m erican

C ollege of O

bstetllcm ns and G

ynecologists (AC O

G ). k

blm s the line, firm

ly dlaw n m

C asey, betw

een pIevia- blhty and postvlabality aboltlO

nS And, fox the fiISt tim e

since R oe, the C

ourt blesses a plohabitlon w ith no excep-

tion safegum dm

g a w om

an's health. I d

isse n

t flo m

th e

C o

ro t's d

isp o

sitio n

R e

tle a

tin g

flom prior rulings that aborhon restrictions cannot be

im posed absent an exception safeguarding a w

om an's

health, the C ourt upholds an A

ct that sm ely w

ould not survive under the close scrutiny that previously attended state-decreed lim

itations on a w om

an's reproductive ch

o ice

s.

IIA T

he C ourt offers flim

sy and tlanspalent justifications foI upholding a natm

nw lde ban on Intact D

& E

sans a n y e

xce p tio

n to

sa fe

g u a ld

a w

o m

e n 's h

e a lth

. T

o d

a y's lu

h n

g , th

e C

o u

rt d e

cla re

s, a d

va n

ce s "a

p re

m ise

ce n

tra l to

[C a

se y's] co

n clu

slo n

"-t.e , th

e G

ovelnm ent's "legitim

ate and substantial Interest m p

le se

lvin g

a n

d p

ro m

o tin

g fe

ta l life

." B u

t th e

A ct

sca rce

ly fu rth

e rs th

a t in

te re

st: T h e la

w sa

ve s n

o t a

sin g

le fe

tu s fro

m d

e stru

ctio n

, fo r it tm

g e

ts o n

ly a m

ethod of perform ing abortion. A

nd surely the

?

p re

g n a n t w

o m

e n . In

sh o lt, th

e C

o ro

t u p h o ld

s a th

a t, w

h ile

d o

in g

n o

th in

g to

"p Ie

se lv[e

]... fe ta

l life," bars a w

om an fiom

choosing intact D &

E !:although her doctoi 'qeasonably beheves [that pio-

edm e] w

ill best protect [hel] " S tenbetg, 530 U

S ,

at 946 (S TE

V E

N S

, J, concurring). A

s another ieason for upholding the ban, the C ourt

em phasizes that the A

ct does not proscÿlbe the nonln- ta

ct D &

E p

m ce

d m

e . B

u t w

h y n

o t, o

n e

m ig

h t a

sk N

onm tact D

& E

could equally be chaiacterlzed as "biutal," involving as it does "tear[rag] [a fetus] apart" and "ripp[ing] off" its lim

bs. "[T ]he notion that elthel

of these tw o equally gruesom

e plocedm es .. is m

ole akin to infanticide than the othel, O

l that the S tate fur-

thels any legitim ate lntelest by banning one but not

the otheI, is sim ply irlatlonal." S

tenbetg, 530 U S

., at 946-947 (S

TE V

E N

S , J, concurling)

D e h ve

ry o f a

n in

ta ct, a

lb e it n

o n via

b le

, fe tu

s w a l-

ra n

ts sp e

cia l co

n d

e m

n a

tio n

, th e

C o

u rt m

a in

ta in

s, because a fetus that is not dlsm

em beled resem

bles an infant. B

ut so, too, does a fetus dehveled intact after it is te

rm in

a te

d b

y in je

ctio n a

d a y o

r tw o b

e fo

le th

e sulgIC

al evacuation, or a fetus dehveled thlough m ed-

ical reduction oi caesm ean Y

et, the availability of those

p lo

ce d

u ie

s--a lo

n g

w ith

D &

E b

y d ism

e m

b e

rm e

n t--

the C orot says, saves the ban on intact D

& E

flora a declaration of unconstitutionality N

evel m ind that the

pm ceduIes deem

ed acceptable m ight put a w

om an's

health at gleatel risk U

ltim ately, the C

ourt adrm ts that "m

olal concerns" axe at w

ork, concerns that could yield piohabltions on a n y a

b o rtio

n N

o ta

b ly, th

e co

n ce

rn s e

xp re

sse d a

re u n te

th e le

d to

a n y g

ro u n d g

e n u in

e ly se

rvin g th

e G

overnm ent's m

telest in preseivm g life B

y allow ing

such concerns to carly the day and case, ovem dang fun-

dam ental lights, the C

ourt dishonols our plecedent R

e ve

a lin

g in

th is le

g a

ÿd , th

e C

o u

rt in vo

ke s a

n antm

bom on shibboleth for w

hich ÿt concededly has n o xe

lia b le

e vid

e n ce

" W o m

e n w

h o h

a ve

a b o ltlo

n s

com e to leglet their choices, and consequently suffer

flo m

"[s]e ve

xe d

e p le

ssio n a

n d lo

ss o f e

ste e m

" B

e ca

u se

o f w

o m

e n 's fra

g ile

e m

o tio

n a l sta

te a

n d

because of the "bond of love the m other has for heÿ

child," the C ouIt w

om es, doctols m

ay w ithhold infol-

m a

tlo n

a b

o u

t th e

n a

tu Ie

o f th

e in

ta ct D

& E

p ro

ce -

dine. T he solution the C

ourt apploves, then, is not to lequlie doctoIs to inform

w om

en, acculately and ade- quately, of the different plocedures and their attendant llsks Instead, the C

orot depxlves w om

en of the right to m

ake an autonom ous choice, even at the expense

n ÿ' th

o 1

1 ÿn

lÿo t'ÿ!

G O

N ZA

LE S

v. C A

R H

A R

T 393

T h

is w a

y o f th

in kin

g re

fle cts a

n cie

n t n

o tio

n s

a b

o u

t w o

m e

n 's p

la ce

in th

e fa

m ily a

n d

u n

d e

a th

e C

o n stitu

tio n --Id

e a s th

a t h

a ve

lo n g sin

ce b

e e n d

ls-

c ie

d lte

d .. .

T hough today's m

ajoaIty m ay regm

d w om

en's feel- in

g s o

n th

e m

a tte

ÿ a s "se

lf-e vid

e n

t," th is C

o u

lt h a

s iepeatedly confirm

ed that "[t]he destiny of the w om

an m

ust be shaped . on hei ow n conception of her S

pll- ltual im

peratives and her place in society" C asey, 505

U S

, at 852

In cases on a "w om

an's hbelty to determ ine w

hethel to [continue] hei pregnancy," this C

ourt has identified via

b ility a

s a critica

l co n sid

e ra

tio n . S

e e C

a se

y, 5 0 5

U .S

, at 869-870 (plurality opinion) "[T]heie is no hne [m

ore w orkable] than viability," the C

orot explained m C

a se

y, fo r via

b ility a

s "th e

tim e

a t w

h ich

th e

re IS

a re

a llstÿc p

o ssib

ility o f m

a in

ta in

in g a

n d n

o u rish

in g a

life outside the w om

b, so that the independent exis- tence of the second life can an reason and all fairness be the object of state protectm

n that now ovelrides the

rights of the w om

an.. In som e bioad sense it m

ight be saÿd that a w

om an w

ho fails to act before viability has consented to the S

tate's inteiventlon on behalf of the developing child." Id, at 870.

Today, the C oult blurs that line, m

aintaining that "[t]he A

ct [legitim ately] appl[les] both plevaabihty and

postvlabihty because . . a fetus is a living organism w

hile w ithin the w

om b, w

hether or not it is viable out- side the w

om b" Instead of daaw

ing the line at viabil- ity, the C

ouit iefers to C ongtess' purpose to differentiate

"aboltlO n and infanticide" based not on w

hether a fetus can sm

w ve outside the w

om b, but on w

hexe a fetus as anatom

ically located w hen a particular m

edical ploce-

dure as perform ed

O ne w

ondeIs how long a hne that saves no fetus

from destruction w

all hold m face of the C

ourt's "m olal

concerns" T he C

ourt's hostlhty to the ught R oe and

C ase), secuied is not concealed. T

hroughout, the opin- ion lefels to obstem

caan-gynecologlsts and surgeons w

ho peiform aboitIons not by the titles of then m

edical specialties, but by the pejorative label "abortion doctor." A

fe tu

s is d e sciib

e d a

s a n "u

n b o rn

ch d d ," a

n d a

s a "b

a b y," se

co n d -tfim

e ste

l, p re

vla b lh

ty a b o ÿtlo

n s a

ie referied to as "late-term

,"; and the reasoned m edical

judgm ents of highly tÿalned doctols m

e dism issed as

"prefeiences" m otivated by "m

ere convem ence." Instead

of the heightened scrutiny w e have previously applied,

the C ourt deteam

m es that a "rational" ground is enough

to uphold the A ct. A

nd, m ost troubling, C

asey's princi- ples, confirm

ing the continuing vitality of "the essential h

o ld

in g

o f R

o e

," a re

m e

re Iy "a

ssu m

e [d

]" fo r th

e m

om ent, rather than "retained" or "reaffirm

ed."

IV

IIIA O

O o o

W ithout attem

pting to distinguish S tenberg and ear-

lier decisions, the m ajority asserts that the A

ct survives review

because respondents have not show n that the

b a n o

n In

ta ct D

& E

w o u ld

b e u

n co

n stitu

tio n a l "in

a large fraction of relevant cases." B ut C

asey m akes

cle m

th a t, in

d e te

rm in

in g w

h e th

e I a

n y re

strictio n

p o

se s a

n u

n d

u e

b u

rd e

n o

n a

"la rg

e fra

ctio n

" o f

w o m

e n , th

e re

le va

n t cla

ss a s n

o t "a

ll w o m

e n ," n

o r

"all pregnant w om

en," nor even all w om

en "seeking

a b o itto

n s." 5

0 5 U

S ., a

t 8 9 5 R

a th

e r, a

p ro

visio n

re strictin

g a

cce ss to

a b

o rtio

n , "m

u st b

e ju

d g

e d

b y

reference to those [w om

en] for w hom

it is an actual ra

th e

l th a

n a

n irre

le va

n t re

strictio n

," ib id

. T h

u s th

e a

b se

n ce

o f a

h e

a lth

e xce

p tio

n b

u rd

e n

s a ll w

o m

e n

fo r w

h o

m it IS

re le

va n t--w

o m

e n

w h

o , in

th e

ju d

g -

m e n t o

f th e ii d

o c to

ls , re

q u ire

a n In

ta c t D

& E

because other procedules w ould place their health

at risk It m akes no sense to conclude that this facial

challenge fails because respondents have not show n

that a health exception IS necessary for a large frac-

tio n

o f se

co n

d -trim

e ste

r a b

o itlo

n s, In

clu d

in g

th o

se for w

hich a health exception is unnecessary: T he

ve ly p

u rp

o se

o f a

h e

a lth

e xce

p tio

n is to

p ro

te ct

w om

en in exceptional cases

• •

F ol the reasons stated, I dissent from

the C ourt's dis-

position and w ould affirm

the judgm ents befoze us for

re vie

w .

T hough today's opinion does not go so far as to dis.::?!

cm d R

oe or C ase),, the C

ourt, differently com posed :}i

than it w as w

hen w e last consadered a IestIm

tlve abor. tio

n re

g u

la tio

n , is h

a rd

ly fa ith

fu l to

o u

i e a

rlie r in

vo .

ca tio

n s o

f "th e ru

le o

f la w

" a n d th

e "p

lln cip

le s o

f ÿ) stare decists" C

ongress Im posed a ban despite our

cleat prior holdings that the S tate cannot pIoscfibe an

abortion procedure w hen its use as necessary to pro-

tect a w om

an's health. A lthough C

ongress' findings could not w

ithstand the crucible of trial, the C ourt

defers to the legislative override of our C onstitution.

based ruhngs. A decision so at odds w

ath our jurzspm .

dence should not have staying pow er

In sum , the notion that the P

artm l-B

irth A bortion

B an A

ct furtheis any legitim ate goveInm

ental interest is, quite sim

ply, irrational. T he C

ouit's defense of the statute provides no saving explanation In candoi; the A

ct, and the C ourt's defense of it, cannot be under-

stood as anything other than an effort to chip aw ay at

a right declared again and again by this C ourt--and

w ith

In cre

a sin

g co

m p re

h e n sio

n o

f its ce n tra

lity to w

o m

e n 's live

s. W h e n "a

sta tu

te b

u rd

e n s co

n stitu

- tional rights and all that can be said on its behalf is that it is the vehicle that legislators have chosen for expressing thm

r hostility to those rights, the buIden is undue" S

ÿrenoerg," 530 U .S

., at 952 (G IN

S B

U R

G , J.,

concurring).

Suggested R eadings for C

hapter 5

ASSISTED REPRO DUCTIO

N AND REPRO G

ENETICS

A n d re

w s, L

O L l B

, a n d D

o u g la

ss, L isa

"A lte

rn a tL

ve R

e p ro

d u ctL

o n "

S outhetn C

ahfot nta Law R

eview 65 (N

ovem ber 1991), 623-82

B u ch

a n a n , A

lle n , B

ro ck, D

a n W

, D a n L e ls, N

o rm

a n , a

n d W

lkle L ,

D a

rn e

l F ro

m C

h a

n ce

to C

h o

ice G

e n

e tics a

n d

Ju stice

C a

m -

budge C am

bndge U nlvelslty P

less, 2000 C

haro, R A

lta "C hddren by C

hoice R eploductLve T

echnologies and the B

oundaries of P ersonal A

utonom y" N

atm e C

ell B iology

S1 (2002), $23-29 C

o h

e n

, C yn

th ia

B "'G

ive M

e C

h ild

re n

O a

I S h

a ll D

ie ' N

e w

R eproductive Technologies and H

aLm to C

hlldLen" H astings

C enter R

eport 26 (1996), 19-27 N

ew W

ays of M aking B

abies The C ase of E

gg D onation

Bloom ington and Indlanapohs, 1N

Indiana U m

verslty Press, 1996 T

he C ouncil on E

thical and Judlcm l A

ffans, A m

erican M edical

A ssocaatlon "E

thical Issues R elated to P

renatal G enetic

Testing" A tclm

,es of Fam dy M

edicine 3 (1994), 633-42 Lebacqz, K

aten "C hoosing O

ur C hLldlen The U

neasy A lliance of

Law and E

thics in John R obeltson's T

hought" In A rthur W

G alston and C

hrlstlana Z P eppard, eds E

xpanding H ot tzons tit

B toethtcs D

ordlecht, The N etherlands S

pringer, 2005, 123-39 M

ackhn, R uth "A

rtlficm l M

eans of R epLoductlon and O

ur U ndel-

standing of the Fam ily, The H

astings C enter R

epm t 21 (1991),

5-11 "W

hat Is W rong w

ith C om

m odlficatlonÿ" In C

ynthia B C

ohen, ed N ew

W ays of M

aking B abies T

he C ase of E

gg D

o n a tio

n B

lo o m

in g to

n a

n d In

d la

n a p o h s, IN

In d ia

n a

U m

velslty P ress, 1996

M ahow

ald, M ary B

rlody G enes, W

om en, E

quahty N ew

Y ork

O xford U

niversity P ress, 2000, ch 12

M cG

ee, G The Perfect Baby Parenthood m

the N ew

W m

Id of C loning

and G enetics Lanham

, M D

R ow

m an &

Lltflefield, 2000 M

urray, T hom

as H T

he W orth of a C

hild B erkeley U

m vezslty of

C ahfornla P

ress, 1996, ch 6 N

elson, H llde Llndem

ann "D ethroning C

hoLce A nalogy, P

er- sonhood, and the N

ew R

eproductw e Technologies" In W

anda Teays and Lam

a M P

urdy, eds B toettncs, Justice attd H

ealth C

are B elm

ont, C A

W adsw

orth, 2001, 555-64 T

he N ew

Y ork S

tate T ask F

orce on Life and the Law A

ssisted R

eproductive Technologies A nalysts and R

econnnendattons fot P

ubhc P ohcy N

ew Y

ork T he N

ew Y

ork S tate T

ask F olce on

Life and the Law , 1998

N oah, Lats "A

ssisted R eploductw

e Technologies and the P Ltfalls

of U nregulated B

iom edical Innovatm

n" F lot ida Law

R eview

55 (April 2003), 603-65 P

arens, E llk, and A

sch, A drLenne, eds P

t enatal T esting attd D

isability R

ights W ashington, D

C G

eolgetow n U

m versLty P

less, 2000 P

a re

n s, E

L lk, a

n d K

n o w

le s, L

o ll P

"R e p lo

g e n e tlcs a

n d P

u b h c

P ohcy R

eflections and R ecom

m endations" T

he H astings

C enter R

eport 33 (July-A ugust 2004), S

1-24

P eteLson, M

M "A

ssisted R epzoductlve Technologies and E

quity of A

ccess Issues" Join hal of M edical E

thics 31 (2005), 280--85 P

L e sld

e n t's C

o u n cil o

n B

lo e th

lcs R e p ro

d u ctio

n a

n d R

e sp

o n stb

th ty

T he R

egulation of N ew

B Iotechnologtes W

ashington, D C

P resident's C

ouncil on B Loethlcs, 2004

P uLdy, Laura "G

enetics and R epLoductlve R

isk C an H

aving C

hLldren be Im m

olalg" In H elga K

uhse and P eter S

inger, eds B

toetlncs A n A

nthology, 2nd ed O xford B

lackw ell P

ubhshm g,

2006, 115-21 R

ao, R adhlka "A

ssisted R eploductlve Technology and the Threat

to the T radlt!onal F

am ily" H

astings Law Jom

nal 47 (A pril

1996), 951-65 R

obm ts, D

ozothy E "R

ace and the N ew

R eproduction" H

asttngÿ Law

Journal 47 (April 1996), 935-49 R

obeltson, John A C

hildren of C hoice F

reedom and the N

ew R

e p ro

d u ctive

T e ch

n o lo

g ie

s P n n ce

to n , N

J P lm

ce to

n U

m ve

lslty P

ress, 1994 -- "P

ro c re

a tw

e L

ib e

rty a

n d

H a

lm to

O ffs

p rin

g m

A s s is

te d

R eplodU

C tlO

n "A m

el ican Join hal of Law &

M edicine 30 (2004),

7-40 R

othenberg, K aren H

, and Thom son, E

lizabeth J, eds W om

en and P

renatal Testing Facing the C hallenges of G

enetic Technology C

olum bus, O

H O

hm S

tate U nlvelslty P

LeS S

, 1994 R

o th

m a

n , B

a lb

a ra

K a

tz T h

e T

e n

ta tive

P te

g n

a n

O , H

o w

A m

n to

- centests C

hanges the E xperience of M

otherhood N ew

Y olk

W W

N oLton &

C om

pany, 1993 R

yan, M anta A

E thtcs attd E

eonom tcs of A

ssisted R eploductton

The C ost of Longing W

ashington, D C

G eolgetow

n U nlvelsLty

Press, 2001 "T

he A lgum

ent fol U nhm

Lted P locreatlve Llbelty A

F em

inist C lltN

ue" H astings C

enter R eport 20 (July-A

ugust 1990), 6-12

S h

e rw

m , S

u sa

n "F

e m

in ist E

th L

cs a n

d In

V ltlo

F e

ltlh za

tm n

" In W

anda Teays and Laura M P

m dy, eds B

toethtcs, Justice and H

ealth C are B

elm ont, C

A W

adsw olth, 2001, 537-42

S llveL, Lee M

R em

aking E den H

ow G

enetic E ngineering attd

C loning W

ill Transform the A

m erican Fanuly N

ew Y

oLk A von

Books, 1998 S

tanw olth, M

lchelle "B irth P

angs C onceptive T

echnologies and the T

hleat to M otherhood" In W

anda T eays and Laura M

P urdy, eds B

toetlncs, Justice and H ealth C

are B elm

ont, C A

W adsw

olth, 2001, 549-54 S

teLnbock, B onnLe Life befm

e B oth N

ew Y

olk O xford U

m velslty

P ress, 1992

-- "S e x S

e le

ctio n N

o t O

b w

o u sly W

lo n g " T

h e H

a stin

g s

C enter R

eport 32 (January-February 2002), 23-28 W

a ch

b ro

lt, R o b e lt, a

n d W

a ssm

m a n , D

a vid

"R e p L o d u ctw

e T

e ch

- nology" In H

ugh LaFollette, ed The O afotdH

andbook of P rac-

tical E thics N

ew Y

olk O xfold, 2003, 136ÿ50

W arnock, M

ary M aking B

abies Is There a R ight to H

ave C luldten

N ew

Y m

k O xfold U

nw elslty P

ress, 2002, 55-63, 87-96

W a

sse ÿm

a n

, D a

w d

, B m

ke n

b a

ch , Je

lo m

e , W

a ch

b rm

t, R o

b e

rt, e d

s

Q uaho, of Ltfe and H

um an D

tffelence G enette Testing, H

ealth C

u te

, a n d D

tsa b tllty N

e w

Y o lk C

a m

b rid

g e U

m ve

a slty P

ÿe ss,

2005

ABO R

TIO N

B e ckw

Jth , F

ÿa n cts "T

h o m

so n 's E

q u a l R

e a so

n a b le

n e ss A

lg u m

e n t

fo l A

b o

m o

n R

ig h

ts A

C n

tN u

e " A

m e

ltc a

n J

o a

ln a

l o f J

u lts

- plndence 49 (2004), 185-98

B I o

w n e , A

h ste

r 'ÿb m

h o n m

C a n a d a " C

a m

b l td

g e Q

u a 1 te

l 1 3 , o

f H

ealthcale E thics 14 (2005-07), 287-91

C allahan, D

aniel, and C allahan, S

idney, eds A bostton U

ndel- standing D

tffelences N ew

Y ork P

lenum P

ress, 1984 C

m d , R

o b e lt F

"T w

o P

u zzle

s F o l M

m q m

s's C o n se

lva tw

e V

ie w

O n

A bornon" B

toethtcs 20 (2006), 264-277

D aw

s, M ichael "F

etuses, F am

ous V m

hm sts, and the R

ight to C

ontinued A id" P

htlosophtcal Q ualtetly 33 (1983), 259-78

D a vis, N

a n cy (A

n n ) "T

h e A

b o rtm

n D

e b a te

T h e S

e a lch

fm C

om m

on G round" P

alts 1-2 E thtcs 103 (1993), 516-39,

731-78

D w

o ÿkm

, R o

n a

ld L

tfe 's D

o m

in io

n A

n A

tg a

m e

a t a

b o

u t A

b o

rtio n

, E

uthanasm and hM

tvtdual F leedom

N ew

Y olk K

nopf, 1993 D

w yer, S

usan, and Fem berg, Joel, eds The P

ÿoblem of A

boÿtton, 3rd ed B

elm ont, C

A W

adsw orth, 1997

E ngelhardt, H

T ustlam

T he F

oundattons ofB toethtes, 2nd ed

N ew

Y ork O

xfold U m

veÿsay P ress, 1996, chap 6

G e

tt, B e

rn a

rd "M

o ra

l D ÿsa

g ÿe

e m

e n

t a n

d A

b o

m o

n " A

u stta

h a

n Joto nal of P

tofesstonal and A pphed E

tlnes 6 (June 2004), 1-19 G

eveÿs, S jef "T

hud T nm

estel A bom

on fm F

etal A bnozm

ahty" Btoethtes 13 (1999), 306-13

G lnsbm

g, R uth B

adeÿ "S om

e Thoughts on A utonom

y and E quahty

m R

elanon to R oe v W

ade" N orth C

atohna Law R

evzen, 63 (1985), 375-86

H all, T

im othy "A

bm tlon, the R

ight to Life, and D ependence"

S octal T

heoly and P ÿaettce A

n hlteJnattonal and httetÿ dtsctphnaty Journal of S

octal P htlosophy 31 (2005-07),

405-29

h a

u ls

, J o

h n

, "T h

e C

o n

c e

p t o

f th e

P e

rs o

n a

n d

th e

V a

lu e

o fÿ

K ennedy Institute of E

thw s Jotoaal 9 (D

ecem ber 199ÿi!

293-308 H

am s, John, and H

olm , S

olen "A bom

on" In H ugh LaFollette, ed!

The O afoJd H

andbook of P m

cttcal E thtcs N

ew Y

ozk O xfordI

2003, 112-35 H

m sthouse, R

osahnd "V ntue Them

y and A box hon" P

htlosophy€ Pabhc Affalps 20 (1991), 223M

6 K

a m

m , F

x a

n c e

s M

C J e

a n

o n

a n

d A

b o

ltto n

N e

w Y

o lk

, O x fo

rd

U m

velslty P ress, 1992

L ittle

, M a rg

m e t O

h w

a A

b o l tto

n , In

ta n a cy, a

n d R

e sp

o n stb

th h e s to

G e sta

te O

xfo rd

C la

le n d o n P

re ss, 2

0 0 3 ÿ;ÿ

M m

qm s, D

"A bom

on and the B egm

m ng and E

nd of H um

an Life.', ÿ!

JouH ral of Law

, M edtclne &

E thtcs 34 (2006), 16-25

M organ, Lynn M

"Life B egins W

hen T hey S

teal Y ore B

icycle:

C ross-C

ultural P ÿacnces of P

elsonhood at the B egm

m ngs and

E nds of Life" JouJnal of Law

, M edw

m e &

E thtes 34 (2006),

8 ÿ 1

5 :ÿ

N oonan, John T

, Jr, ed T he M

om hty of A

bottton Legal and

H tstoH

cal P eÿspeetn,es C

am bridge, M

A H

m vard

P ÿ e

s s , 1

9 7

0 U

m v e

rs ÿ ty

P e

ÿsso n , In

g ra

in "H

m m

m g

th e

N o

n -C

o n

scm u

s" B to

e th

te s 1

3

(1999), 294-305 P

ojm an, Louts p, and B

eckw ÿth, F

ÿancÿs J, eds T he A

bottton

C ontÿovetsy B

oston Jones and B m

tlett, 1994

Q um

n, W anen "A

bom on Idennty and Loss "p]idosolÿ/O

, ÿ P ubhe

Affm ts 13 (1984), 24-54

R egan, T

om , ed M

attets of Ltfe and D eath 3ÿd ed N

ew Y

oÿk: R

andom H

ouse, 1992 R

h o d e n , N

a n cy K

"A C

o m

p ro

m ise

o n A

b o rtm

n " H

a stin

g s C

e n te

r

R eport 19 (1989), 32-37

S um

ner, L W A

boÿtton aadM om

l Theory P nnceton, N

J P unceton

U m

veÿsÿty Pÿess, 1981

Thom son, Judith Jarw

s "R ÿghts and D

eaths" P hdosophy &

P ubhc

Affatÿs 2 (1973), 146--55 T

ube, Laurence H A

bottton T he C

lash of A bsolutes N

ew Y

ork' N

orton, 1990

W anen, M

m y A

une "T he M

oral S ignificance of B

nth" In W anda

Teays and Laura M P

m dy, eds B

w etlue.ÿ, Justtee and H

ealth C

ute B elm

ont, C A

W adsw

orth, 2001, 477-80

te r 6

ath and D ying

Introductzon

recent decades patients have dem anded, and physacm

ns have given, greater defelence p

a tie

n ts' w

ish e

s le g

a ld

ln g

h o

w th

e y w

ill d ÿe

. R e

sp e

ct fo r a

p a

tie n

t's a u

to n

o m

y h a

s grow

n to encom pass a patient's decaslons about hfe-sustaanlng treatm

ent and w hether to

.hasten death B ut w

hat are the paeclse boundaIaes of the legitim ate plactlce of m

edaclne w

hen patients lequest help in ending then lives9 T hele is no consensus am

ong health cam the publac, oa in publac policy about this m

attei. M any physicians feel

stiongly that, undea appropim te caacum

stances, assistance an hastening death ÿs a legiti- m

a te

fo rm

o f a

d d le

ssa n g a

p a tie

n t's n

e e d s, b

u t o

th e r p

h ysicia

n s a

re e

q u a lly stro

n g ly

opposed to thas adea The baoethics com m

unity is slm alatly divided. The m

oral problem s

underlying this plofound dlsagleem ent m

e addlessed in the plesent chapter.

KEY TER M

S AN D

D ISTIN

C TIO

N S

P hysicians and nurses have long w

oalied that if they w ithdaaw

treatm ent and a patient

dies, they w all be accused of kflhng the pataent A

paialM concern exists that patients w

ho refuse life-sustaining taeatm

ent oa hasten death are killing them selves and that health pao-

fessionals assist an the suacade af they com ply w

ath lefusals or satisfy lequests to Iefuse taeatm

ent. A related concea'n is that physicians w

ho help patients "actively" hasten the tim

e of thear deaths m e Involved eather an physacian-assisted suacade or euthanasaa. W

hat do these key m

olal notaons refer to and w hat as then m

oral am port?

T he D

istm ctton betw

een K tllm

g and Lettm g D

te. T hose w

ho aeject physaclan assis- tance m

hastenang death often distinguish betw een overseeang a refusal of tIeatm

ent and a

ssistin g

in a

su icid

e T

h e

y g ro

u n

d th

is d lstin

cta o

n a

n th

e d

lffe a

e n

ce b

e tw

e e

n "le

ttin g

die'and "kilhng" T his dastlnctaon IS

applied to distinguish betw een paactlces consideied

pelm asslble from

paactices that aa'e alw ays lm

peim lssible. W

ithdiaw als or w

lthholdlngs of treatm

ent have generally been classified m the "letting dae" category--depending on the

nature of the illness and the antent of the physicm n In its ordlnaiy language m

eaning, ktlhng m

plesents a fam ily of ÿdeas w

hose central condltaon is dlaect causation of another's death, w

heleas letttng die lepresents anothei fam ily of Ideas w

hose central condatlon as Intentaonal avoadance of anteaventaon so that a death as caused by a disease, m

juIy, oa som e

othel "natural" cause This distinction betw

een killing and letting die ÿs contloversm l. A

peison can be kalled by lntentm

nally lettang htm o1" her die of a "natulal" condition of disease w

hen the death should have been prevented by a physÿcaan ff a physician rem

oves a aespaaatox from a

patient w ho needs it and w

ants to continue to use at, the action as w iong, even though the

physacian has only iem oved altlficlal life support and let nature take its couise A

bsent