Numerous complications can result from pregnancy. Some are more common than others and some are more dangerous than others. The important question then arises: are any complications in a pregnancy sufficient to morally permit an abortion? No.
Consider this argument for support:
(1) If directly killing the unborn child is morally worse than letting the mother die, then directly killing the unborn child is morally worse than (a) having the mother undergo nonfatal harm and (b) increasing the risk that the mother will die.
(2) Directly killing the unborn child is morally worse than letting the mother die.
(3) Therefore, directly killing the unborn child is morally worse than (a) having the mother undergo nonfatal harm and (b) increasing the risk that the mother will die.
I shall not argue for (1). However, I do think it is prima facie plausible (given some restrictions and explanations on what nonfatal harm amounts to and how much risk is increased). If you think letting the mother die is morally worse than having her undergo nonfatal harm or simply increasing the risk that the mother will die, then you should also accept (1).
In what follows, I argue for the extremely controversial premise, premise (2). I argue that there are some circumstances where it would be morally wrong to abort even if the woman’s life is on the line. That is, I argue that directly killing the unborn child is morally worse than letting the mother die. By showing this, I satisfy (2). Furthermore, assuming (1) is true, we can conclude (by the logical rule of inference modus ponens) that abortion is immoral at least in the following two cases: (a) if the presence of the unborn child causes nonfatal harm to the mother and (b) if the presence of the unborn child increases the risk that the mother will die.
I should mention that my argument for (2) presupposes the success of a previous article I wrote: “A Challenge to Pro-Choicers: on Behalf of the Little Ones.” In that article, I argued that aborting an unborn child is just as morally wrong as murder. If you were not convinced by that article, which I suspect many are not, then consider my conclusion to be conditional: if aborting an unborn child is as morally wrong as murder, then there are some circumstances where it would be morally wrong to abort even if the woman’s life is on the line. I should also mention that this article is only meant to provide the skeleton for the conclusion. It would require at least a large tome to provide the meat.
First I should set the stage a little more. I am envisioning this type of hypothetical scenario as the background for (2). Suppose some pregnant woman, Emily, has some complications late in her pregnancy. The doctor tells her and her husband, David, that either she has to abort her unborn child or she dies. However, if Emily dies, the unborn child can still be saved. Of course what Emily actually does is going to be determined, in part, by the long and complicated discussions that her and David will have together. In this article, I am not concerned with what people would actually do in such a circumstance—to each his own. Rather, I am concerned with what morality requires of us in such a circumstance. That is, I am concerned with what people should do in such a circumstance. Is there a moral requirement here? In a word, yes. I argue that it would be morally worse for Emily to abort her unborn child in such a circumstance.
It is important to point out that such cases are unheard of in the 21st Century, though they might have occurred prior to the advances in modern medicine: in cases of Dystocia. But this exercise in normative ethics is meant for a much more relevant conclusion. It’s meant to show the truth of (3), which is highly relevant. The reason I use this approach is because it is somewhat exhaustive. By arguing for one thing, we can get many things—as opposed to looking at each case and giving a separate argument for each situation.
The first step of my argument is to show that consequentialism is false. Consequentialism is an ethical theory about what makes actions right or wrong. According to this theory, the only thing that is morally relevant to an action is the consequences of the action. In other words, nothing contributes to the moral status of an action other than its consequences. As such, the morally right action is the one that maximizes the right type of consequences. But what type of consequences are the right ones? The answer to that question depends on what type of consequentialist you are. If you are a utilitarian (like John Stuart Mill and Jeremy Bentham), then pain and pleasure are the only consequences of an action that are relevant to its moral status.
For example, suppose some guy is considering whether lying to his friends is morally right. In order to figure this out in utilitarian fashion, he must consider all the right consequences of the action. That is, he must consider not only the pains and pleasures that this action would cause him, but he must also consider the pains and pleasures that it would cause his friends (and others who might be affected by the action). If the overall outcome of this action maximizes pleasure and minimizes pain, then it would be morally right to lie in this case. For the sake of argument, I assume that utilitarianism picks out the right type of consequences. Not much turns on this assumption since the objection I present can be modified for other versions of consequentialism.
Utilitarianism is false because it has obvious counterexamples. Consider the famous transplant example. Suppose I need to get a tonsillectomy. Unfortunately for me, my doctor is a diehard utilitarianist. And in the next room, five patients are in desperate need of an organ transplant. Without the transplant, they will die. Upon reflection, the doctor decides to put me under, take out my organs, and distribute them among the five patients to maximize utility. To make sure that his actions will maximize utility, the doctor figures out that (a) I don’t have a family or any close friends who would miss me, (b) the five patients have lots of good relationships with their family and friends, and (c) no one will find out if he distributes my organs (suppose I am in a country where those types of things go unnoticed). In this situation, utilitarianism morally requires the doctor to distribute my organs. But surely that is not the morally right thing to do! Our pre-theoretical moral intuition cries out against this morally heinous act! In this example, utilitarianism gives us the wrong answer. Just like how the claim “all crows are black” would turn out false if just one instance of a white crow is discovered, utilitarianism is false because it gives us the wrong answer in this instance. The white crow would be a disconfirmation of the universal claim. Similarly, this counterexample is a disconfirmation of utilitarianism. The transplant case is one counterexample; there are many others but no need to rehearse them here.
Not only does the transplant example show that utilitarianism is false, but it also shows that the consequences of an action are not the only things that are morally relevant. This does not mean consequences are not relevant at all. Rather, it means that when we consider whether an action is morally right, one should do more than simply consider the consequences of the action. Now that I have made logical room for non-consequentialism (the view that consequences are not the only morally relevant things), let us move to the next step of the argument.
The second step is to point out an often overlooked distinction. The distinction is between killing and letting die. Contrast the following two examples to pick out the difference. First example: Suppose Deborah is hiking in Yorkshire Dales National Park in the UK. With her are two friends, Joseph and Matt. Due to poor navigational skills, they end up getting lost. While trying to find their way back, they cross paths with a grizzly bear and her cubs (there are no grizzlies in Yorkshire Dales; but I wasn’t about to put a ferocious badger in the example). This is bad news. The bear becomes aggressive, and they all bolt for it. Unfortunately, Joseph and Matt stumble and fall. Deborah quickly turns back, grabs Matt (the favored one and also the one farther away from her), and continues to run. And that is the end for poor Joseph. Second example: recall the first example except in this case not only do they fall, but Joseph falls on top of Matt. Moreover, in this second case, Deborah turns back, throws Joseph off of Matt (causing Joseph to fall on the bear, making her even more aggressive), grabs Matt, and then they run away.
What is the difference between the first and second example? In the first example, Deborah saves Matt, but she let Joseph die. In the second example, Deborah saves Matt, but she causes Joseph to be killed! After all, in the first example, the bear might have passed Joseph and kept going after Matt and Deborah. In the second example, however, Deborah sealed the deal by directly causing Joseph to fall on the bear. Surely there is a significant moral difference between the two examples. Letting one die is not as morally tragic as killing someone. One might question whether Deborah did something morally wrong by helping the favored one in the first case. But even if there is a hint of immorality in the first case, it cannot come close in degree to the second case. In the second case, Deborah’s actions are highly questionable, to say the least—way more questionable than the first case.
At this point, it should become apparent why the first step of my argument is necessary. Consequentialism does not leave room for the distinction between killing and letting die because all it cares about are the consequences of the action. For consequentialism, all things being equal, Deborah’s actions in both cases are morally the same because they had the same consequences: in each case, Joseph lost his life. But this is clearly false. The second example, unlike the first, is morally worse. And the distinction in question makes this clear.
Now I am going to tie everything together. With the two steps in mind (consequentialism is false and the distinction between killing and letting die), let us return to Emily’s unfortunate circumstance. In Emily’s situation, there are two lives on the line: the life of the mother and the life of the unborn child. If Emily does not abort her unborn child, she will die. In this situation, why is it morally wrong to abort the unborn child? –because aborting will directly kill the unborn child! However, if we allow things to naturally take their course, then there is no agent that is directly killing the mother (like there is if the unborn child is aborted). Instead the doctors are letting the mother die in order to not directly kill the unborn child. Since in this situation, aborting the unborn child will be an intentional killing as opposed to letting him or her die, it would be morally worse to kill the unborn child than to let the mother die. Therefore, all things being equal, it seems morally worse for Emily to abort her unborn child in this circumstance. As such, we get (2). And hence we get (3). QED.