A debate was organised the other night by edmedethics – ‘Abortion in the 21st century – the medicine, the ethics and the law.’ Mrs Ann Furedi (Chief Executive of BPAS, the British Pregnancy Advisory Service) presented the case that abortion provision is not only pragmatically defensible but ethically justifiable; Prof John Wyatt (professor of neonatal pediatrics at UCL) argued that there was ‘nearly always’ a better alternative to abortion.
The points of agreement between the two speakers were remarkable. Furedi pointed out that women who come to abortion clinics are “never” there to exercise “their political right to choose” – they would often have done anything to avoid being there, and it’s never an easy decision. As she also said, “we all want to work really hard to avoid abortions” – the rising rate of abortions is undoubtedly a concern, she said, as undergoing the procedure is “unpleasant, stressful, and usually distressing.”
The main disagreement therefore focused on what, in practical terms, should be the options available to a woman who did not feel she could continue with a pregnancy. Furedi argued that women should not be compelled to continue with a pregnancy against their will – the option to end it should always be available. Wyatt argued that there is always a better alternative. It might not be an easy alternative, he said, but there was nearly always a better alternative. He focused on the situtations and pressures that give rise to women’s feeling that there is no alternative but to end the pregnancy. In contrast to Furedi’s emphasis on the value of individual autonomy, he said that many women have an abortion not so much as a triumph of personal autonomy but precisely because they don’t see an alternative – under what influences, he asked, are women making these choices? – especially when their apparently autonomous decisions so often seem to serve other people’s interests.
Wyatt also mentioned the concept of the image of God. Furedi had argued for a distinction between ‘biological’ life and life that somehow “matters” – life that is conscious, self-aware, self-valuing, for example. But rather than making a division between those who have self-awareness and those who don’t, Wyatt pointed to the Judaeo-Christian principle that all human life is special – humans have intrinsic value whether they are self-aware and self-valuing or not. In considering ‘abortion in the 21st century,’ therefore, his question was how as a society we can best support each other to value and preserve all human life.
Questions from the floor were generally thoughtful, but I was particularly struck by one brave soul who suggested that the problem lies somewhat prior to the pregnancy itself – surely society should recognise, she offered, that sex is not an end in itself but does have consequences. This was shot down by Furedi, who pointed out that that’s simply not how society sees things today. But Wyatt did concur that there is a “murky, seedy side to our permissive society” – unwanted pregnancy is not the only consequence of risk-free casual promiscuity – there are questions about relationships, and people’s (especially women’s) self-worth and self-esteem, as significant social pressures which make up the context in which unwanted pregnancies occur.
What came across clearly was the concern of both speakers to deal compassionately with women in difficult circumstances and a recognition (on both sides, I felt) that abortion is not something to reach for as an easy way of solving people’s problems. The discussion was characterised by great courtesy and mutual respect, without the speakers compromising on the plain presentation and robust defence of controversial principles. And, somewhat similar to the (albeit rather less valuable) discussion on “assisted dying” last week, what distinguishes the practical response of both sides is in the perceived need they target – the unwanted pregnancy, or the circumstances which make it unwanted. Providing women (and couples) with the support they need in order not to go through with unpleasant procedures to terminate pregnancies would, surely, be a mark of a healthier and more caring society.