THE ETHICS of BEGINNING-OF-LIFE HEALTH CARE, PART IV: KILLING for the PURPOSES of MEDICINE

We are once again considering the wrongfulness of direct abortion and, more generally, the deliberate killing of human beings in the early stages of their development. We will recall that the term “abortion” refers to the death of an unborn child in the womb of his or her mother and the resulting termination of her pregnancy. A direct abortion is defined as the deliberate killing of such a child, which is always morally wrong. There are other kinds of abortions that are not direct abortions. There are also other kinds of direct killings of newly developing human beings that are not abortions. Morally speaking, it does not matter whether the killing takes place inside or outside of the womb. Deliberately killing an innocent human being is always the wrong thing to do.

There are a number of medical purposes for which people might be inclined to kill innocent human beings in the early stages of their development. One of those purposes is the advancement of medical research. The most notable example of that is embryonic stem cell research. For embryonic stem cell research to be possible, human beings must be artificially conceived in order that their stem cells can be extracted. What remains of those newly conceived humans is then discarded. New stem cells can then be produced without conceiving and destroying additional human embryos, but the killing of newly developing human beings remains necessary for initiating new embryonic stem cell lines. For the purposes of our present reflection, we need not consider the morality of experimenting on stem cells derived from human beings who have been conceived and destroyed for that purpose. We can simply to observe that the killing of those human beings for the sake of embryonic stem cell research is direct killing that is deliberately chosen and morally wrong.

As in the cases of direct abortion when the mother has been raped or when her life in in danger, the purpose that motivates these killings is good and praiseworthy. In this case, the good purpose is the advancement of medicine and the effective treatment of disease. But we must again recall the moral principle that “the end does not justify the means.” We ought not do something evil in order to bring about a good result. The advancement of medicine and the effective treatment of disease are worthy goals that are rightly pursued. They do not, however, justify the deliberate destruction of innocent human lives.

We might grasp this principle more easily in cases when non-human animals are killed for the sake of medical experimentation. In those cases, our society seems more ready to conclude that medical researchers must find ways of accomplishing their purposes that do not involve unjust treatment of animals. We should apply this reasoning all the more when the injustice in question is the killing of innocent human beings.

Another purpose for which newly developing human beings are made to die is the management of fertility. That includes methods aiming to achieve pregnancy and methods aiming to prevent pregnancy. When a couple aims to achieve pregnancy naturally, spontaneous abortions sometimes occur. Spontaneous abortions are regrettable and can cause great sorrow for parents. However, they are not anyone’s fault. There is no moral wrong or cause for blame, since the death of the child is in no way chosen.

When a couple aims to achieve pregnancy by in vitro fertilization (IVF), abortions, as well as deaths of newly conceived human beings outside of the womb, can occur. In order to maximize the odds of successful fertilization and implantation, multiple human beings are typically conceived and many are discarded. The destruction of these human lives, not unlike the lives that are lost to spontaneous abortion, is regrettable. In this case, however, the deaths of the children are deliberately chosen. IVF involves the conception of human beings with the intention that most will be destroyed. Those who cause these deaths are, therefore, engaged in direct killing.

Methods of avoiding pregnancy can sometimes result in early abortion when, instead of preventing conception, they prevent a newly conceived human being from implanting in the uterus of his or her mother. In this way, some pills that are intended to act as contraceptives can instead act as abortifacients, instruments of bringing about abortion. Other pills are intended to be abortifacients, destroying already conceived human beings rather than preventing their conception. In either case, abortion caused by deliberately taking such pills would be direct abortion, because it would be foreseeably brought about by a deliberately chosen act.

This would be different that the case of the removal of a pregnant but cancerous uterus the we considered in a previous reflection (July 8, 2018). In that case, the good result that is intended, namely the removal of the life-threatening cancerous organ, is a good proportionate to the unintended evil that is the death of the unborn child. In the case of abortifacient pills, it is doubtful that the intended good of preventing pregnancy would be similarly proportionate. What is not in doubt is that, in this latter case, the intended good effect is brought about be means of the evil effect. Taking abortifacient pills therefore runs afoul of our principle that “the end does not justify the means.”

To be sure, many people who take contraceptive pills are not aware of their possible abortifacient affects. Such people cannot be held fully responsible for the abortions they bring about through those choices. However, those abortions are still direct abortions and are therefore morally wrongful, even if those who choose them are not fully responsible for the wrongfulness of what they choose.

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