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Abortion and Maternal-Fetal Care

Background and Statistics

  • Induced Abortion
  • 42 million performed in 2005
  • 46 million in 1995
  • 1.2 million in U.S. in 2005 and 8% less than in 2000
  • 60% in the first 8 weeks
  • 8% 8-12 weeks

Ashley Patterson, Melanie Monfrey, & Joleen Parker

From the theological perspective, the nonpersonal position is inadequate for two main reasons:

The Social & Legal Status of Abortion in the United States

1) Humans are inseperably physical & material, creative & spiritual, relational & social, as well as morally free & responsible.

2) It fails to recognize the developmental dimension of human life. We are, in fact, one and the same individual, just at different stages in our natural course of development.

Types of Abortion Procedures

From the theological perspective, the nonpersonal position is arbitrary. It lacks any inherent reason for why only a person is deserving of moral respect and protection.

Why do you think women have abortions?

ECG

First Trimester

62

bpm

  • Vaccuum Aspiration
  • Earlier than 9 Weeks-
  • Medical Abortion
  • RU486

Intentions

Second and Third Trimester

Nonpersonal Position:

  • Indirect Abortion- a side effect
  • Direct Abortion- the main effect
  • 13-15 weeks-
  • Dilation and Evacuation
  • 16 weeks and later-
  • Dilation and Extraction

The sanctity of life is founded on the intrinsic moral worth of ahuman life, that is, human dignity, considered as the basis of our rights and moral responsibilities.

Within the Christian and Judaic religious traditions, it's rooted in the concept of imago Dei "image of God". Human beings are made in the image and likeness of God and are destined for eternal union with God. We are all called God's children.

Is a fetus protected under the Fourteenth Amendment?

The Ruling Declares

  • 1st Trimester- The decision to abort is a medical judgment belonging to the woman physician
  • 2nd trimester- states may regulate abortion as long as they allow for exceptions to protect the woman;s health
  • 3rd Trimester- states are permitted to regulate and even prohibit abortion

Regarding the moral status of the fetus, two of the predominant views can be described as the nonpersonal position and the personal position.

Roe vs. Wade (1973)

It's influenced by moral relativism and dualism.

Example: Roe v. Wade and

Parenthood v. Casey

A fetus does not deserve the same respect and is not capable of functioning in ways characteristically associated with being a person.

A fetus is not a person but only a "potential person".

Planned Parenthood vs. Casey

  • Required doctors to inform women about detriments to health in abortion procedures
  • The spousal notice rule required women to give prior notice to their husbands
  • The parental notification & consent rule required minors to receive consent from a parent or guardian prior to an abortion
  • A provision that imposed a 24 hour hold before obtaining an abortion
  • The last provision was to report mandates on facilities providing abortion services

Intersection of Law, Public Policy, Ethics & Abortion

When does life begin?

Should and at what point is human life deserving of our protection and respect?

Should a fetus be considered a person?

During Conception?

Should an embryo have the same respect & protections as members of the community?

When the baby takes its first breath ?

When the fetus attains viability?

(PPACA) Patient Protection & Affordable Healthcare Act

vs.

(USCCB) U.S. Conference of Catholic Bishops

  • Legislation requires multistate insurance exchanges
  • Includes a permanent tax credit for parents who adopt
  • Allocates $25 million a year for supporting pregnant or parenting women who are considered vulnerable to society.

Mind-Body Dualism:

Supreme Value of Autonomy

The idea that a human being is essentially a body inhibited by a mind.

The view holds that the body and the mind are two distinct, independent realities. The body is most closely associated with being human, while the mind is more closely associated with what makes someone a person.

"Cogito Ergo Som" = "I think, therefore I am"

Philosopher Rene' Descartes

Ethical Relativism:

Human life is seen as having a basic intrinsic value because people are made in the image and likeness of God.

We have autonomy precisely because we are made in the image and likeness of God.

Viewed theologically- life, the most basic of values, enabling all other values to be pursued.

Three main characteristics that influenced the public debate on the moral status of unborn life:

1) Ethical Relativism

2) Mind-Body Dualism

3) Supreme Value of Autonomy

The view that what is right or wrong is relative to a particular group of people or an individual. No moral truths.

The role of ethics in prescribing what one ought to do to promote human flourishing is limited to the individual or private sphere of life.

Respect for Autonomy & the Moral Status of Early Human Life

Discussion:

The ethical debate of abortion begins with the question:

When should the product of conception be considered a person deserving of moral respect and protection?

Ethical Issues & Analysis

Legalization of Abortion

Throughout most of U.S. history abortion has been illegal. As of 1965, abortion at all stages of pregnancy was prohibited by law.

What was the landmark that changed the prohibition of abortion?

Personal Position:

The personal position on the moral status of unborn life is based on three key claims:

The product of conception deserves absolute respect and protection from the time the process of fertilization is complete.

1) Genetically unique human life come into being at the moment the process of fertilization is complete.

2) Science alone cannot answer the philosophical question of when personhood begins but can only confirm the biologicalpoint at which human life begins.

3) Regardless of whether the embryo is a person, it is a grave sin to disrupt the biological process of human developmen once started.

The Most Common Reason Women Have Abortions

Abortion and the Sanctity of Life

  • A sense of being too young to be a mother
  • Not wanting a disabled child
  • The absence of a partner to help raise the child
  • Pressure from the genetic father
  • A pregnancy that resulted from a sexual assault
  • A lack of financial resources

From the perspective of our normative basis, the question of personhood is not the only, or even the main question regarding abortion. Rather four other questions:

1) What value does early human life have?

2) What respect does it deserve?

3) What is the nature

of our relationship as individuals and as communities with early human life?

4) Who are we called to be in that relationship?

Obeying God intellectually and freely means that we use our intelligence and experience to carry out God's purpose creatively and discern for ourselves what is right and wrong as understood in light of human flourishing, virtue, and right relationships.

In the clinical context, the ethical questions related to the termination of pregnancy are especially difficult when we acknowledge the reality of the sanctity and dignity of human life and the fact that we are already a community with early human life.

Case 3

Case 2

Case 1

Every human being should be acknowledged as an inherently valuable member of the human community and as a unique expression of life.

Conclusion

Right to Life

#1 Legal & Ethical Debate Surrounding Abortion

In The United States

  • Is a fetus considered a person and, therefore, a member of the moral community?

How do we do good when evil cannot be avoided, as in cases of maternal-fetal vital conflict?

Whose life should we save?

Which course of action best promotes human flourishing in a community?

What should we do when we have information regarding a fetal anomoly, but no theraputic or curative invention?

To whom do we have the greater obligation, the mother or the unborn baby, when conflicting values are at stake?

Christi is 22 weeks pregnant and has been diagnosed with sever preeclampsia (very high blood pressure induced by pregnancy) which has not improved with antihypertensive medications and in-hospital bed rest. The ob-gyn overseeing Christi's care is very concerned about her condition and thinks the best option is to induce delivery immediately, despite the lethal consequences for the baby. She knows, though, that despite the considerable risks to Christi, they could take the chance and forestall delivery a little longer to give the baby an opportunity to live. After discussing this with Christi, they both agree that the risks to Christi are too great and the outcome for the baby is uncertain to wait any longer: thus, Christi is scheduled for an immediate induction.

An 18-year-old female is admitted to the ER with preterm labor. Ultrasound reveals that she is 32 weeks pregnant. The emergency physician immediately initiates drugs to stop the contractions and stall labor for a time. The physician also administers coticosteroids to strengthen the baby's lungs in the event that the baby is delivered early. The ob-gyn on call is consulted and requests that the woman be brought to the labor and delivery unit. After reviewing the girl's ultrasound, the ob-gyn notes that the baby is in breech position, which means that a C-section will most likely be required. The girl's labor continues to progress, and fetal monitoring shows that the baby is experiencing fetal distress. The ob-gyn informs the girl that an emergency C-section will have to be done to save the baby. The girl, however, states that she "does not want to be cut into" and refuses to give her consent for the procedure. The ob-gyn insists it must be done and the girls grandmother, who has been with her since entering the ER, intervenes and says, "My granddaughter has made her wishes known." Furious, the ob-gyn points out that, "the baby will die or be severely impaired if a C-section is not done immediately." The grandmother does not give in, however, and says that "God will do with the baby what he wills," and that if anything is done against her granddaughter's wishes, she will bring suit against the ob-gyn and the hospital. A staff nurse concerned about the situation calls for an ethics consult.

Stacey , who is 41 years old and 15 weeks pregnant, has just been told her fetus has a condition known as anencephaly, in which the "higher" brain fails to develop. The baby will never be conscious and never e able to think or talk. It has a brain stem, though, which controls bodily functions, such as breathing, heartbeat, and sucking reflexes. The doctor says that if the baby is carried to term it will die within a week of being born, if not sooner. The condition poses no serious threat to Stacey's health, but the physician suggests to Stacey that it might be better to terminate the pregnancy instead of carrying to term due to the psychological burden of knowing that her baby will die shortly after being born. Some of the nurses object, arguing that the fetus should be given a chance to live as long as possible, while others think the decision ought to be Stacey's alone insofar as the baby is going to die anyway.

  • Under what conditions and through what procedures can terminating a pregnancy be consistent with our human life and hence morally acceptable?

In tragic circumstances of maternal-fetal conflict in which the life of the mother, fetus, or both is threatened we cant rely on principles alone. Virtue and prudence is almost, always necessary to help us decide what the most loving response is regarding the circumstances.

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