Abortion: An ethical dilemma

Abortion, the intentional termination of a pregnancy through surgical or medical devices, was legalized in 1973. This issue of abortion has caused a great segregation in our country. Often the debate is thought to be conservative versus liberal, republican versus democrat, but more accurately it is pro-life versus pro choice. A pro-life stance opposes the belief that a woman should have the freedom to choose an abortion in the case that for any reason she does not want to have a baby. Pro-choice takes the opposite stance; pro-choice is a belief that a women should have the autonomy to chose an abortion in the case of an unwanted pregnancy (Freesearch, 2005). Difficult questions get thrown around between the two views. Where does life begin? Should a woman have complete autonomy over her healthcare decision involving her body? What about in the case of disease and rape, are we more concerned with the wellbeing of the mother or the fetus? Issues such as nonmaleficience and beneficence, justice, autonomy, and quality of life come into play.

Should we as healthcare professionals, deliberately cause harm to a fetus to maintain the autonomy of the mother? Is it just to deny complete autonomy to the mother while simultaneously denying justice and autonomy to a potential life? From a virtue ethical prospective, the answers to the difficult questions and actions taken depend on the innate moral values of the individual. For example, a Christian would derive their moral values from the Bible which describes life as preconceived before physical birth; whereas, an atheist would be more likely to believe happiness for the greatest number is the ultimate goal (utilitarianism). Since abortion is viewed as such a morality issue, controversies arise between people with different moral codes.

As a potential healthcare professional, I realize I will be bombarded with patients considering abortions and those who have previously had one. I must know where my position, so when I am approached with the issue I can properly educate my patient while not compromising my values. As a Christian, my foundation comes from the Bible. Jeremiah 1:4-5 proclaims, “I (God) knew you before you were formed within your mother’s womb; before you were born I sanctified you and appointed you as my spokesman to the world.” Here God clearly states that He knew Jeremiah, the unborn, before he was conceived and had a purpose for him. A prominent question in this ethical dilemma is “Is this life preconceived?” And if it is, “Do we have the autonomy to terminate this potential being?”

A pro-choice stance supports the women’s complete autonomy in her healthcare. They believe that life does not begin with the fertilization of an egg, but instead the most widely held view is that life begins at viability, the point at which a fetus has a living chance of surviving without being attached to the mother. Since the unborn fetus is not a living being, instead it is simply a mass of tissue that is part of a women’s body, abortion is just an autonomous healthcare decision of a women (Prochoice.com, 2004). By taking away the freedom to have an abortion, you are stripping women of complete autonomy in health care. What happens in the case of rape? A rape victim did not actively choose to become pregnant. Pro-choice advocates argue that we should not force a woman to live with the consequence of an act of violence; this would be unjust towards the mother.

Furthermore, not only the mother may suffer, a child brought into this world as a result of rape or a mistake young girl with no means to raise a child will compromise the quality of life not only for the mother, but also for the child. Where is the justice in bringing a child into the world destined for a poor quality of life? Pro-choice supporters should not be mistaken for pro-abortion. They do not encourage abortions as a type of birth control. The do endorse sex education in schools as well as providing affordable contraceptives for all sexually active women. Alternatives are also presented; however, if the woman desires to terminate the pregnancy she should have the right to control her body. It is believed that the health care decisions should be made by the individual not to be persuaded by politicians or legislation (Prochoice.com, 2004). Depending on where her virtues stand, her decision should be completely autonomous.

From a pro-life prospective life begins at conception. When a sperm fertilizes an egg an impending baby is formed. A heart beat begins around eight to twelve weeks after conception a body systems are present eight weeks after conception; therefore, conception is the beginning point of life (Answers.com, 2005). Since murder is considered the active preconceived termination of life, abortion, to a pro-life supporter, would be a form of murder.

Not only is the pro-life argument based on protection of the fetus, it is also concerned with the wellbeing of the women. Consider this story. Christi, a remarkably friendly and outgoing seventeen year old girl was devastated; her world as she knew it was suddenly crumbling to pieces. Frantic over her undesired situation, Christi and her parents could only think of one solution: abortion. The day after Christi’s eighteenth birthday, her mother drove her to the Mayfair Women’s Clinic in Aurora, California, hoping to solve the intruding problem that had arisen. Christi and her mother’s fears diminished when they saw how clean and professional the clinic seemed to be. The doctor led Christi into a counseling room before they proceeded with the surgery. Christi was informed of the possible complications related to the procedure, but was ensured that the risks were minimal (Dunigan, 2000). Christi then followed the doctor into the operating room; little did she know her world was about to change.

During the operation, Christi went into full cardiac arrest. They rushed her to the hospital; when her mother finally arrived Christi was secured to a respirator, heart monitor, and IV tubes. Christi had severe brain damage. Never again would Christi walk, talk, see, hear, feel, or think. All Christi has left are occasional reflexes. Christi’s life was changed in a matter of minutes as a result of one choice (Dunigan, 2000). Statistically 4.1% (1 of 24) of all abortion patients suffer physical complications. After an abortion, one can experience intense pain, hemorrhaging, stillbirths, organ damage, infection, damage to the uterus, infertility, increased risk of future miscarriages, premature births, an increased risk of breast cancer, or even death (Katz, 2005). Paula, a friend of my mother’s claimed that abortion was the most painful experience of her life. She was never told the effect I would have on her body.

The doctor stretched her cervix, which was the most excruciating pain she had ever felt. Then he took a suction device and sucked the once whole and active fetus out in several pieces. Paula stated that her whole insides felt as if the were being pulled out of her body. Not only did Paula experience immediate pain, but also her internal organs were damaged. She had to undergo a complete hysterectomy; now she will never again have children. Abortions not only affect the physical wellbeing of the mother, but also the emotional. Since the legalization of abortion, suicide rates have sky-rocketed. Sixty-five percent of all mothers who have had abortions have suicidal urges, and thirteen percent actually attempt suicide. Eighty-one percent of abortion victims suffer from depression; seventy-seven percent acquire low self esteem, and sixty one percent become drug or alcohol addicts- these are few of many emotional effects that may follow abortion (Mulier, 1990).

Kathy, another victim of abortion claims, “After my (suction) abortion I had heavy bleeding and severe cramps…two days later I ‘passed’ my baby. He had tiny hands and feet, and I could make out his little nose. I was horrified! Sorry overwhelmed me… Years of turmoil followed. The relationship with the baby’s father dissolved…so did my belief in love. I drank too much, did drugs, and entertained any man who would look at me. I was starved for acceptance (Mulier, 1990, 20).” These statistics and personal testimonies (only 3 of approximately 1,400,000 abortions in the U.S. this year) depict the horrendous aftermath of such an act as abortion. You must decide whether the emotional turmoil that accompanies abortion is worth the elimination of ones supposed “intruding convenience,” another life.

How can you make your decision? Consider the Chally and Loriz ethical decision making model (1998) and follow the six steps: clarify the ethical dilemma, gather additional data, identify other options, make a decision, act, and evaluate. To clarify the dilemma as yourself who the problem concerns, who should make the decision, and what ethical dilemmas are involved (Chally & Loriz, 1998). As a future health care professional, it concerns me and my patients. I must be able to educate my patients on the complications (emotional and physical), alternatives, and positive aspects of an abortion. However, I must still not compromise my values. I must present the principles of autonomy, quality of life, beneficence, and nonmalificence. When gathering additional data, I must keep myself up-to-date on current issues and legal cases. Make sure I am adequately informed to make a decision.

I must weigh alternatives such as abortion. And after I have thoroughly informed myself and weighed my options, I can make a decision on where I stand. But simply being informed is not sufficient. It takes action to make a difference, and if an individual is really passionate about his/her stance she will be sure to act accordingly. Take part in elections, research candidates and where they stand on abortion. Educate your patients; and professionally defend your position. Lastly frequently evaluate yourself. Are you still informed? Have you continued to educate yourself on the issue, and do you express your opinion in a nonjudgmental professional manner.

Since 1973 over two million abortions have been performed in the United States alone. This is more fatalities than all the American wars combined (Katz, 2005). Think about how many beneficial human beings could be living today if abortion were illegal in the fifty-four countries (sixty-one percent of the world population) in which abortions are performed. Yes, sometimes these pregnancies derive from unwanted situations; emotional turmoil follows the pregnancy. However, this emotional turmoil is short-lasting. These purposed children can touch so many lives in such colossal ways by the most insignificant act, who are we to say which life is worth living? How are we to know that a great thing can not come out of a bad situation such as rape or mental retardation? Even if the quality of life is compromised for one, another life may be so drastically improved by the mere existence of this person. God says in Jeremiah 1:5, “Before I formed you in the womb I knew you, before you were born I set you apart.” It is hard for me to support the termination of a preconceived, purposed, potential life. If any pregnant women thought of her perspective child as the next president, doctor, or even possibly the long awaited founder of the cure for cancer, she would probably thing twice about killing that intended child.

References:

Answers.com. (2005). Pro-Life. Retrieved March 13, 2005 from:

http://www.answers.com/topic/pro-life

Chally, P.S., & Loriz, L. (1998). Ethics in the trenches: Decision making in practice.

American Journal in Nursing, 98(2), 17-20.

Dunigan, Christina. (2000). Christi’s Choice: How a safe and legal abortion destroyed a

colorado family. Retrieved April 8, 2005, from

http://home.bluemarble.net/~heartcom/christi’schoice.html.

Freesearch (n.d.). Pro-life-Pro-choice. Retrieved April 8, 2005, from

http://www.freesearch.co.uk/dictionary/prolife.

Katz, N. (2005). Abortion statistics. Retrieved April 8, 2005, from

http://womensissues.about.com/cs/abortionstats/a/aaabortionstats.htm.

Mulier, Judy. (1990, March). The abortion is long over, but the pain is still there. Living World

Magazine, 20.

Prochoice.com. (2004). Empowering women to make informed choices. Retrieved March 12,

2005 from : http://www.prochoice.com/abort_how.html.