Abortion.

[inked]

Originally Posted by The Gaffer

Agreed.

I agree with all of what you said, Inked


You said that there are circumstances in which the mother's choice should be paramount, and rape would be one of those cases.

Does this indicate that you regard the unborn child as qualitatively different from the born child? Clearly, one wouldn't kill the baby of a rape victim. In what way/s is the foetus different, in terms of rights, to a baby?

The Gaffer,

I mentioned the so-called hard cases because while I knw what my particular viewpoint is and how I think I would react in those situations, I am not saying that is the only possible response. In point of fact, the baby conceived as a result of rape is an innocent and women historically have been forced to carry those infants (for the most part of time to term). Perhaps, they should still. Perhaps not. That decision is not one I would necessarily make for them. There are moral points of view which elevate this continuance to a mandatory condition when expressed in full rigour (as in the moral teaching of the Roman Catholic Church) and this is consistent within that belief system.

As regards genetic abnormalities and incompatible life syndromes, as I noted earlier in this thread, invdividual couples make choices out of their belief systems and I have seen the entire gamut of reactions and choices made. When faced with that decision in my own case, preliminary testing suggested such a condition, but the decision to continue the pregnancy even if the condition was established was made on a priori grounds consistent with our beliefs.

Qualitatively for me the person begins at fertilization - at the union of the sperm and the egg. The journey to implantation takes 4 to 7 days and is fraught with the failure of implantation. Supersensitive PGcy tests have been used in studying the loss of Pgcy prior to implantation and suggest that perhaps 40-50% of fertilizations may fil of implantation. Once implanted the failure of the Pgcy (now established clinically by usual PGcy tests) ranges from 16 - 25% (the natural miscarriage rate). I am ignoring the rate of ectopic gestation. After 12 to 14 weeks from the last menstrual period, if there has been no bleeding or threat of miscarriage rate, the spontaneous miscarriage rate falls to ~3%. It is the number of these clinically established PGcies that results in the denominator for birth rates which are further defined usually as #events/live births. Then there are all the potential problems of PGcy like preterm labor, premature rupture of membranes, etc.
Assuming a normal PGcy course, some babies will still have the various genetic problems or enzyme defects or congential problems. (But you must remember this is what I do for a living and have done for over 2 decades.)

For me personally then the whole person is present from fertilization but that by no means every fertilization will result in the birth of a baby. Technically, the pregnancy is medically defined as initiating at implantation (which definition was changed from fertilization to allow for reproductive technologies and experimentation within my lifetime).

So, I personally only perform abortions if the life of the mother is at stake. And I have had patients who chose to continue risky PGcies - knowing the risks - who did die after giving birth to their child. Those who chose otherwise have been referred to appropriate service providers.

By the by, hormonal contraceptives prevent ovulation as their primary means of contraception. I do not regard the prevention of ovulation as in the same moral category as abortion, but some do. Also, I do not place IUDs as their function is prevention of implantation as opposed to prevention of ovulation.

So the subject is complex, but I strive for consistency. It will be immediately obvious that I have made certain concessions outside of my personal beliefs to society. I think no one gets through life without compromise. I maintain my beliefs and practice in a certain tension which I think is weighted towards the baby with due consideration of the mother. I am privileged to be in the only are of medicine that puts one patient into the bed and takes two or more out.