Ethical Issues Surrounding Abortion and Roe v. Wade

Introduction

Notwithstanding the laws being passed in various states against a woman's right to choose to terminate her pregnancy, the position of this paper is that Roe v. Wade is the law of the land and that a woman has the ethical and moral right to decide to have an abortion. There are many positions for and against Roe v. Wade, and there are many ethical issues that may be — and in many cases are — embraced on both sides of the issue. But the law of the land regarding a woman's right to privacy — concerning her own values — when it comes to terminating a pregnancy has been determined by the High Court. As a nurse committed to fairness and ethics in healthcare issues, while I respect the rights of others to practice their own values in opposition to Roe v. Wade, I support a woman's absolute right to choose what should happen to her body.

Statistical Overview of Abortion in the United States

There were approximately 1.21 million abortions performed in the U.S. in 2008, according to combined data from the Centers for Disease Control and the Guttmacher Institute. This was a drop from about 1.29 million abortions in 2002. The Kaiser Family Foundation reports that there were 1.21 million abortions performed in 2005, down from 1.61 million in 1990. Kaiser also reports that about 49% of pregnancies in the U.S. were "unintended," and of those unintended pregnancies, 42% resulted in abortions. There are two kinds of abortions: surgical abortions and medical abortions.

The Kaiser Family Foundation explains that 87% of all abortions are surgical, involving procedures such as vacuum aspiration, dilation and curettage (D&C), and dilation and evacuation (D&E). In most cases, surgical abortion is not performed until the pregnant woman is in her sixth week of gestation. The "medical abortion" is performed using the drug known as RU-486 (mifepristone), which was approved by the U.S. Food and Drug Administration in 2000. RU-486 can be administered any time following confirmation of pregnancy, and in 2005, about 13% of all abortions were performed using it, according to Kaiser statistics.

A 2012 report from Medline Plus, a component of the National Institutes of Health, shows that abortion rates among teenagers in the U.S. fell to record lows in 2008 due to increased use of contraceptives. About 750,000 women in the U.S. under the age of 20 became pregnant in 2008, and 98% of those women were between the ages of 15 and 19 — the lowest rate of teen pregnancies since 1972, as writer James B. Kelleher explains. The abortion rate for teenage girls also dropped to its lowest level since 1972: 17.8 per 1,000 teenage girls and women received abortions in 2008, down 59% from 1988, when 43.5 per 1,000 teenage women received abortions (Kelleher, 2012).

That said, African-American and Latino teenagers had pregnancy and abortion rates "two to four times higher than their white peers," according to the Guttmacher Institute, a nonprofit sexual health research organization. The prevailing explanation is that African-American and Latino teenage females do not have the same access to contraceptives as Caucasian teenage females (Kelleher).

Ethical Issues and Abortion

Abortion became a legal option for women in the United States in 1973 when the U.S. Supreme Court ruled that under the U.S. Constitution, women have a right to privacy that protects "the right to choose whether to continue a pregnancy to term or to have a safe and legal abortion" (Planned Parenthood). In the peer-reviewed journal Nursing Standard, Jones and Chaloner provide arguments for and against abortion. The anti-abortion position, constructed through deductive reasoning, runs as follows:

Premise A: The fetus is an innocent human being. Premise B: It is morally wrong to kill an innocent human being. Conclusion: It is therefore morally wrong to kill a fetus.

The pro-abortion position presented by the authors is as follows:

Premise A: The fetus has no moral status. Premise B: It is not morally wrong to destroy something that has no moral status. Conclusion: It is not morally wrong to destroy a fetus.

Given these two opposing premises, it then seems logical to examine the accuracy of the premises themselves (Jones, et al., 2007, p. 45). The authors delve into several auxiliary ethical issues, beginning with the terms "pro-life" and "pro-choice." A person can be both pro-life and pro-choice, because someone claiming to be pro-life may also "be an advocate for freedom of choice in areas other than abortion," given that this approach supports individual rights (Jones, 46). Moreover, a pro-choice person may support a woman's right to an abortion while simultaneously opposing the legalization of euthanasia — and hence be pro-life in that regard (Jones, 46).

Another ethical issue discussed in the article is technological: science is currently using stem cells in the search for treatments for diseases such as Parkinson's disease, spinal cord injuries, Alzheimer's disease, and other serious medical conditions. Stem cells can be obtained from aborted fetuses, creating significant ethical dilemmas. A "father's rights" issue is also relevant to the abortion debate; specifically, whether a father of an unborn baby should have the right to participate in the woman's decision. This issue has gained traction in recent years, Jones explains (46). Additionally, many states require parental consent before a minor can receive an abortion — raising the question of whether the state has the right to require a 17-year-old girl to obtain her parents' permission.

Regarding the moral status of the fetus, Jones points to the most pertinent question in this debate: "when does the embryo/fetus acquire a moral value, and beyond this point, is it wrong to interfere with it?" (46). There is clearly a difficulty in determining at which point during the process from conception to birth "beyond which abortion should not be permissible," according to the pro-life position. But is that point when the fetus has a human appearance, or when it can sense pain? This is a profound moral and ethical dilemma, as Jones explains (46).

Jones also presents the "maternal vs. fetal rights" framework, which essentially pits the value of a grown female human against the value of a fetus. Feminist activists argue that for a woman "to have equal rights regarding sexual freedom, abortion must be freely available," since in all other situations in which adults are considered competent to make their own informed decisions, the autonomy of a woman is respected (Jones, 47). Women should therefore have the opportunity to make decisions regarding their own bodies and should not be "forced to act against their wishes" (47). The fetal rights perspective, by contrast, claims that if fetal life at that early stage is "equal to that of any other human being, it may be claimed that society has a moral duty to protect it" (Jones, 47).

Given these opposing positions, either the rights and life of the fetus are equal to those of a grown female, or they are not. The pro-choice viewpoint holds that: (a) the fetus is "only a potential life which is reliant on the pregnant woman for existence," and (b) the woman is "already an individual, fully formed life and must, according to this view, have preference over the potential of the fetus" (Jones, 47).

Yet another ethical issue raised by Jones in Nursing Standard is that if a doctor determines during a woman's pregnancy that the fetus will be severely abnormal or disabled, an abortion can be morally justified — or at least legally justified in some jurisdictions — on grounds of "serious handicap" (47). But this raises the difficult ethical question: how do we define "handicapped"? What precisely constitutes a serious physical handicap? Each country, and within the U.S. each state, must make those difficult determinations. For example, if it is determined that a child has Down syndrome, does that justify an abortion? The pro-life camp would disagree with that conclusion, and many in the pro-choice camp might also be reluctant to abort a child solely because of a serious mental disability.

Conclusion

It is the position of this paper, based on the ethical points raised, that Roe v. Wade is justified — and should be left intact — as a law that protects a woman's right to choose to terminate her pregnancy. Both sides of the issue should also strive to find common ground and seek ways to reduce the number of abortions. This paper strongly agrees with a peer-reviewed article in the Journal of Religious Health that "for many women, religious doctrine may be balanced with secular logic as both are important and inextricably linked determinants of decision making about the termination of pregnancy" (Stephens, et al., 2009).

Works Cited

Abort73. (2010). U.S. Abortion Statistics. Retrieved April 16, 2012, from http://www.abort73.com.

Glionna, John M. (2012). Arizona passes law restricting abortion. Los Angeles Times. Retrieved April 16, 2012, from http://www.southbendtribune.com.

Jones, K., and Chaloner, C. (2007). Ethics of abortion: the arguments for and against. Nursing Standard, 21(37), 45–48.

Kaiser Family Foundation. (2008). Fact Sheet: Women's Health Policy Facts / Abortion in the U.S.: Utilization, Financing, and Access. Retrieved April 16, 2012, from http://www.kff.org.

Kelleher, James B. (2012). Teen pregnancy, abortion rates at record low, study says. Medline Plus. Retrieved April 15, 2012, from http://www.nim.nih.gov.

Manninen, Bertha Alvarez. (2010). Rethinking Roe v. Wade: Defending the Abortion Right in the Face of Contemporary Opposition. The American Journal of Bioethics, 10(12), 33–46.

Nobis, Nathan. (2011). Abortion, Metaphysics and Morality: A Review of Francis Beckwith's Defending Life: A Moral and Legal Case Against Abortion Choice. Journal of Medicine and Philosophy, 36(3), 261–273.

Planned Parenthood. (2011). Honoring Roe v. Wade. Retrieved April 16, 2012, from http://www.plannedparenthood.org.

Stephens, Moira, Jordens, Christopher F.C., Kerridge, Ian H., and Ankeny, Rachel A. (2010). Religious Perspectives on Abortion and a Secular Response. Journal of Religious Health, 49(4), 513–535.