Retail magnate convicted in kidney-for-sale case ceases control of CK Tang
By Desmond Wong, Channel NewsAsia | Posted: 27 August 2008 2055 hrs
SINGAPORE: Tang Wee Sung, former executive chairman of CK Tang, has been convicted of two offences under the Human Organ Transplant Act (HOTA) and Oaths & Declaration Act.
As a result, he has ceased to be the executive chairman and director for the company and any other Tangs-affiliated firms.
CK Tang has stated that this will not affect the daily running of the retailer, as its operations are currently undertaken by CEO, Foo Tiang Sooi.
Mr Ernest Seow has been appointed as non-executive chairman with immediate effect.
Tang, who was charged in July, pleaded guilty to two of three charges on Wednesday.
The first charge is for agreeing to buy a kidney and the other, for lying to the Commissioner of Oaths. The third charge - of lying to the Mount Elizabeth Hospital's Transplant Ethics Committee - will be taken into consideration during sentencing next week.
Thursday, August 28, 2008
Wednesday, August 27, 2008
Medical Ethics (Conventions and Codes)
The Declaration of Geneva
(World Medical Association, 1948, 1968, 1983)
Recited at the time of being admitted as a member of the medical profession:
I solemnly pledge to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude which is their due;
I will practice my profession with conscience and dignity;
The health of my patient will be my first consideration;
I will respect the secrets which are confided in me, even after the patient has died;
I will maintain by all means in my power, the honor and the noble traditions of the medical profession;
My colleagues will be my brothers;
I will not permit considerations of religion, nationality, race, party politics, or social standing to intervene between my duty and my patient;
I will maintain the utmost respect for human life from its beginning even under threat and I will not use my medical knowledge contrary to the laws of humanity;
I make these promises solemnly, freely, and upon my honour.
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International Code of Medical Ethics
(World Medical Association, 1949, 1968, 1983)
Duties of Physicians in General:
A physician shall always maintain the highest standards of professional conduct.
A physician shall not permit motives of profit to influence the free and independent exercise of professional judgement on behalf of all patients.
A physician shall, in all types of medical practice, be dedicated to providing competent medical services in full technical and moral independence, with compassion and respect for human dignity.
A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.
The following practices are deemed to be unethical conduct:
Self advertising by physicians, unless permitted by the laws of the country and the Code of Ethics of the National Medical Association.
Paying or receiving any fee or any other consideration solely to procure the referral of a patient or for prescribing or referring a patient to any source.
A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences.
A physician shall act only in the patient's interest when providing medical care which might have the effect of weakening the physical and medical condition of the patient.
A physician shall use great caution in divulging discoveries or new techniques or treatment through non-professional channels.
A physician shall certify only that which he has personally verified.
Duties of Physicians to the Sick
A physician shall always bear in mind the obligation of preserving human life.
A physician shall owe his patients complete loyalty and all the resources of his science. Whenever an examination or treatment is beyond the physician's capacity he should summon another physician who has the necessary ability.
A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.
A physician shall give emergency care as a humanitarian duty unless he is assured that others are wiling and able to give such care.
Duties of Physicians to each other
A physician shall behave towards his colleagues as he would have them behave toward him.
A physician shall not entice patients from his colleagues.
A physician shall observe the principles of the "Declaration of Geneva" approved by the World Medical Association.
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Declaration of
Preamble: It is the privilege of the medical doctor to practice medicine in the service of humanity, to preserve and restore bodily and mental health without distinction as to persons, to comfort and to ease the suffering of his or her patients. The utmost respect for human life is to be maintained even under threat, and no use made of any medical knowledge contrary to the laws of humanity. For the purpose of this Declaration, torture is defined as the deliberate, systematic or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason.
1. The doctor shall not countenance, condone, or participate in the practice of torture, or other forms of cruel, inhuman, or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty, and whatever the victim's beliefs or motives, and in all situations, including armed conflict and civil strife.
2. The doctor shall not provide any premises, instruments, substances, or knowledge to facilitate the practice of torture or other forms of cruel, inhuman or degrading treatment or to diminish the ability of the victim to resist such treatment.
3. The doctor shall not be present during any procedure during which torture or other forms of cruel, inhuman, or degrading treatment is used or threatened.
4. A doctor must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible. The doctor's fundamental role is to alleviate the distress of his or her fellow men, and no motive, whether personal, collective, or political shall prevent against this higher purpose.
5. Where a prisoner refuges nourishment and is considered by the doctor as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent doctor. The consequences of the refusal of nourishment shall be explained by the doctor to the prisoner.
6. The World Medical Association will support, and should encourage the international community, the national medical associations, and fellow doctors, to support the doctor and his or her family in the face of threats or reprisals resulting from a refusal to condone the use of torture or other forms of cruel, inhuman, or degrading treatment.
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Regulations in Time of Armed Conflict
(World Medical Association, 1956, 1957, 1983)
These regulations or guidelines sets out the WMA's standards on the medical ethical position of the physician during a period of war or other armed conflict. The statement was approved by the 10th World Medical Assembly in
Regulations in Time of Armed Conflict
Medical ethics in time of armed conflict are identical to medical ethics in time of peace, as established in the International Code of Medical Ethics of the World Medical Association. The primary obligation of the physician is his professional duty; in performing his professional duty, the physician's supreme guide is his conscience.
The primary task of the medical profession is to preserve health and save life. Hence it deemed unethical for physicians to
Give advice or perform prophylactic, diagnostic, or therapeutic procedures that are not justifiable in the patient's interest.
Weaken the physical or mental strength of a human being without therapeutic justification.
Employ scientific knowledge to imperil health or destroy life.
Human experimentation in time of armed conflict is governed by the same code as in time of peace; it is strictly forbidden on all persons deprived of their liberty, especially civilian and military prisoners and the population of occupied countries.
In emergencies, the physician must always give the required care impartially and without consideration of sex, race,nationality, religion, political affiliation or any other similar criterion. Such medical assistance must be continued for as long as necessary and practicable.
Medical confidentiality must be preserved by the physician in the practice of his profession.
A physician shall use great caution in divulging discoveries or new techniques or treatment through non-professional channels.
A physician shall certify only that which he has personally verified.
Duties of Physician to the Sick
A physician shall always bear in mind the obligation of preserving human life.
A physician shall owe his patients complete loyalty and all the resources of his science. Whenever an examination or treatment is beyond the physician's capacity he should summon another physician who has the necessary ability.
A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.
A physician shall give emergency care as a humanitarian duty unless he is assured that others are willing and able to give such care.
Arguments in “A Defense of Abortion” done by Mr Jarrod Lee
Against Abortion
P1: The development of a human being from the point of conception through birth into childhood is continuous.
C1: To draw a line anywhere in this development is to draw it arbitrarily.
Ø NB: At this point, Thomson advances a version of the argument which is not necessarily the only version available.
Thomson’s version
P2: An arbitrary choice is a choice for which in the nature of things, no good reason can be given
C2: We should not make arbitrary choices (P2)
C3: We should not draw a line anywhere in the development of a human being from the point of conception through birth into childhood (C1, C2)
C4: We had better say that a foetus is a human being, a person, from the point of conception. (C3)
Counterargument via Counterexample
P1: The development of an acorn into an oak tree is continuous
C1: To draw a line anywhere in this development is to draw it arbitrarily. (P1)
P2: The path of development of an acorn is similar to that of a foetus
P3: It does not follow from P2 that we had better say that an acorn is an oak tree
C2: It does not follow that we had better say that a foetus is a person from the point of conception (P2, P3)
Ø But has Thomson deliberately presented a weak version of the argument against abortion?
Stronger version of Argument against Abortion
P1: The development of a human being from the point of conception through birth into childhood is continuous.
C1: To draw a line anywhere in this development is to draw it arbitrarily.
P2: To define what constitutes a person is important and has important ramifications
P3: We should not decide anything that is important arbitrarily.
C2: We had better say that the foetus is a person from the point of conception. (P2, P3)
Ø Does the addition of P2 make the argument stronger now and harder to resist? Why?
In any case, Thomson, as we have seen, does not rely on such a method to try and argue for abortion.
Indeed, what she has done is to be charitable and accommodates the argument against abortion, i.e. that she allows the argument that a foetus is a person from the point of conception to pass through.
Still, she seems to be able to put forth a convincing case for abortion, although she has had to weaken her case such that it is morally permissible (as opposed to morally laudatory) only for certain types of abortion and not all types.
This is what usually happens when you accommodate your opponent’s argument. But it doesn’t matter if your argument is not as strong, extreme and absolute as you had initially thought it would be. What is more important is whether your argument, at the end of the day, is logical and true.
Thomson’s question
Does it follow from the premise that a foetus is a person from the point of conception that we should never allow abortion?
Possible Argument against Abortion
C2: We had better say that the foetus is a person from the point of conception. (P2, P3)
P4: Every person has a right to life
C3: The foetus has a right to life (P4)
P5: No doubt the mother has a right to decide what shall happen in and to her body
P6: A person’s right to life is stronger and more stringent than the mother’s right to decide what happens in and to her body
C4: A person’s right to life outweighs a mother’s right to her body (P5, P6)
C5: A foetus may not be killed
P7: Abortion is to kill a foetus
C6: Abortion denies the right to life of a foetus (P7)
P8: We should not do anything that denies the right to life of any person
C7: We should not perform abortion (P8, C6)
Thomson then goes on to present a thought experiment to show that this argument is flawed.
Thought Experiment: World famous Violinist
P1: All persons have a right to life
P2: The right to life outweighs your right to your body
C1: You cannot be unplugged from the violinist
Counterargument
P1: You did not consent to having the violinist hooked up to you
P2: The violinist has no relation to you such that you have a duty towards him
P3: If you did not consent to him being hooked up to you and you have no duty towards him, then you have no obligation to stay hooked up to him
C1: You have no obligation to stay hooked up to him (P1, P2, P3)
P4: To bear a baby is like to be hooked up to the violinist
C2: You have no obligation to bear a baby (C1, C2)
Ø Note that Thomson does talk about rape victims – But as she pointed out, it sounds weird that your right to life should depend on whether you are the product of rape or not.
Extreme View Against Abortion (impermissible even to save mother’s life)
Scenario: Either the mother lives or the foetus lives (and not both)
P1: To abort is to directly kill the foetus
P2: To not do anything to save the mother is simply to let her die
P3: The foetus is innocent, has committed no crime and is not aiming at his mother’s death.
4 possible P4
P4a: Directly killing a person is always and absolutely impermissible
P4b: Directly killing an innocent person is murder and murder is always and absolutely impermissible
P4c: One’s duty to refrain from directly killing an innocent person is more stringent than one’s duty to keep a person from dying
P4d: If one’s only options are directly killing an innocent person or letting a person die, one must prefer letting the person die
C1: We should not abort even in the case when the mother’s life is at stake.
Thomson: P4a – P4d are all false
P4b – Can’t be murder if the mother performs an abortion on herself to save her life
Focus now shifts to Third Party Intervention
Why? Because there’s not much a mother can safely do to abort herself.
Thus, according to Thomson, “the question asked is what a third party may do, and what the mother may do, if it is mentioned at all, is deduced, almost as an afterthought, from what it is concluded that third parties do.
Objection!
P1: To treat the mother in such a manner is to treat her as an afterthought
P2: To treat someone as an afterthought is not to treat her as an end in herself
P3: A person is an end in herself
C1: To treat someone as an afterthought is to deny them the status of a person (P2, P3)
C2: To treat the mother in such a manner is to deny her the status of a person (P1, C1)
Thought Experiment: Tiny house, Giant Child
Scenario: Either we save the mother by doing something to stop the child growing or we allow the child to continue growing and eventually crush the mother to death.
P1: It is understandable that a bystander cannot choose between the mother and the child
Q: Does it then follow that a mother can do nothing to save her own life?
Thomson: No! You can do something to save your own life! You don’t have to wait passively for the child to crush you to death.
Argument?
P1: Everyone has the right to self-defense, including a mother
P2: To attack the child and stop it from growing, even if it results in the death of the child, is to act in self-defense
C1: The mother has the right to attack the child and stop it from growing, even if it results in the death of the child.
But! As Thomson points out, there are limits to this argument: you do not have the right to do absolutely anything to save your life.
Claim: If someone threatens you with death unless you torture someone else to death, I think you have not the right, even to save your life, to do so.
P1: The right to self-defense does not include the right to do anything whatever to save your life
C1: There are certain things you cannot do in order to save your life (P1)
P2: To torture someone is an atrocious act, one worse than killing the person who is threatening you
P3: The things you cannot do in order to save your life are atrocious acts, ones worse than killing the person who is threatening you
C2: The right to self-defense does not give you the right to torture someone in order to save your life (C1, P2, P3)
The question to ask here is WHY?
Thomson simply states it, assuming that it is an obvious argument that anyone would agree with. But is it really such an intuitively right argument?
What is involved in the Right to Self-Defense? Or rather, what kind of response is allowed in the Right to Self-D?
According to Law, a Proportionate response to the threat you face. So, a modified version of Thomson’s argument might go like this:
P1: The right to self-defense does not include the right to do anything whatever to save your life
P2: A sanctioned response is one that is proportionate to the threat you face.
C1: There are certain things you cannot do in order to save your life, i.e. that your response to the threat you face must be proportionate (P1)
P2: To torture someone is always and everywhere a disproportionate response
C2: The right to self-defense does not give you the right to torture someone in order to save your life (P2)
But what makes P2 true? Can P2 be disputed? Or is it simply trivially true?
Think
New Twist in the Argument
Thomson: Is the Right to Life as unproblematic as we think it is?
Thought Experiment: Henry Fonda
Scenario: Only Henry Fonda’s touch can save you
P1: You have a right to life
P2: Only Henry Fonda’s touch can save you
P3: Henry Fonda is in a far-off country
C1: It would be nice if he can come to save you (P1, P2, P3)
P4: To be nice to someone is not the same as to be obliged to do something for someone.
C2: Henry Fonda has no duty to come to save you even though it would be nice of him to save you (C1, C4)
P5: If it is not a duty to do X in order to save your life, then it is not under your right to life
P6: Henry Fonda has no duty to come to save you (C2)
C3: For Henry Fonda to come to save you is not under your right to life.
(P5, P6)
P7: To use another person’s body continually for a long period of time is similar to Henry Fonda coming down to save you
C4: Having the right to life does not guarantee having either a right to be given the use of or a right to be allowed continued use of another person’s body – even if one needs it for life itself. (C3, P7)
C5: You can unplug the violinist from you, resulting in his death, and it would not be an unjust act. (C4)
C6: The right to life does not consist in the right to be killed (C5)
Ø So what does the right to life consists of if not the right not to be killed?
Thomson: the right not to be killed unjustly
Argument of Unjust Killing
P1: If you do not kill him unjustly, then you are not violating his right to life
P2: You are not killing him unjustly
C1: You are not violating his right to life (P1, P2)
Ø Implications of this argument?
Thomson: “it is by no means enough to show that the foetus is a person and thus has a right to life – we need to be shown also that killing the foetus violates its right to life, i.e. that abortion is unjust killing.”
P1: The relationship between Henry Fonda and you is similar to the relationship between a mother and her baby where the mother did not choose to have the baby in the first place and her life is at stake.
P2: The foetus’ right to life does not consist in not being killed but in being killed unjustly
C1: The mother does not violate the foetus’ right to life by abortion. (P1, P2)
Voluntarily calling it into existence VS Involuntary Impregnation
P1: The foetus has the right to the mother’s body if it was voluntarily called into existence by the mother
P2: To abort the foetus in such a situation is to violate its right to the mother’s body
C1: Abortion in such a circumstance is to kill the foetus unjustly (P1, P2)
P3: The foetus has no right to the mother’s body if it was not voluntarily called into existence by the mother
P4: To abort the foetus in such a sitation is not to violate its right to the mother’s body
C2: Abortion in such circumstance is not to kill the foetus unjustly (P3, P4)
Minimally Decent Argument
P1: There are cases in which it would be morally indecent to detach a person from your body at the cost of his life
P2: One such case is when it is only slightly inconvenient for you to keep him alive
C1: In such cases, you would be indecent if you were to unplug the person from your body (P1, P2)
Ø Does it follow then that if it is decent for you to act in such a manner that the person has a right to your body?
Thought-Experiment: Box of Chocs
Scenario: One box of chocs, two brothers. Box given to elder. Elder just eats, refuses to give to younger who pleads.
P1: The elder has a right to the box of chocs
P2: The younger has no right to the box of chocs
C1: The elder is not obliged to share the box of chocs with the younger (P1, P2)
C2: It would be decent of the elder to share his box of chocs with the younger and not a duty (C1)
Argument with Henry Fonda Part Deux
P1: Henry Fonda is just next door
P2: A touch of his hand on my fevered brow would save me
C1: He is obliged to come and save me (P1, P2)
Objection!
Thomson: How can it be that I have a right to him saving me just because he is now nearer when I did not enjoy the right earlier because he was further away?
Conclusion: To be decent is not the same as to fulfill one’s duty
Thomson’s Argument: Good VS Minimally Decent Samaritan
P1: Nobody is morally required to make large sacrifices, of health, of all other interests and concerns, of all other duties and commitments, for nine years, or even for nine months, in order to keep another person alive.
P2: To save another’s life when it is only a slight inconvenience on you is to be minimally decent
P3: To save another’s life when it is a large sacrifice on your part is to be a Good Samaritan
C1: Nobody is morally bound to be a Good Samaritan (P1, P2, P3)
C2: Abortion, in some cases, would be not be minimally decent (P2)
P4: We should at least be minimally decent
C3: Abortion, in some cases, should not be performed (C2, P4)
A Defense of Abortion by Judith Jarvis Thomson
{47} Most opposition to abortion relies on the premise that the fetus is a human being, a person, from the moment of conception. The premise is argued for, but, as I think, not well. Take, for example, the most common argument. We are asked to notice that the development of a human being from conception through birth into childhood is continuous; then it is said that to draw a line, to choose a point in this development and say "before this point the thing is not a person, after this point it is a person" is to make an arbitrary choice, a choice for which in the nature of things no good reason can be given. It is concluded that the fetus is, or anyway that we had better say it is, a person from the moment of conception. But this conclusion does not follow. Similar things might be said about the development of an acorn into an oak tree, and it does not follow that acorns are oak trees, or that we had better say they are. Arguments of this form are sometimes called "slippery slope arguments"—the phrase is perhaps self-explanatory—and it is dismaying that opponents of abortion rely on them so heavily and uncritically.
I am inclined to agree, however, that the prospects for "drawing a line" in the development of the fetus look dim. I am inclined to think also that we shall probably have to agree that the fetus has already become a human person well before birth. Indeed, it comes as a surprise when one first learns how early in its life it begins to acquire human characteristics. By the tenth week, for example, it already has a {48} face, arms, and legs, fingers and toes; it has internal organs, and brain activity is detectable.2 On the other hand, I think that the premise is false, that the fetus is not a person from the moment of conception. A newly fertilized ovum, a newly implanted clump of cells, is no more a person than an acorn is an oak tree. But I shall not discuss any of this. For it seems to me to be of great interest to ask what happens if, for the sake of argument, we allow the premise. How, precisely, are we supposed to get from there to the conclusion that abortion is morally impermissible? Opponents of abortion commonly spend most of their time establishing that the fetus is a person, and hardly any time explaining the step from there to the impermissibility of abortion. Perhaps they think the step too simple and obvious to require much comment. Or perhaps instead they are simply being economical in argument. Many of those who defend abortion rely on the premise that the fetus is not a person, but only a bit of tissue that will become a person at birth; and why pay out more arguments than you have to? Whatever the explanation, I suggest that the step they take is neither easy nor obvious, that it calls for closer examination than it is commonly given, and that when we do give it this closer examination we shall feel inclined to reject it.
I propose, then, that we grant that the fetus is a person from the moment of conception. How does the argument go from here? Something like this, I take it. Every person has a right to life. So the fetus has a right to life. No doubt the mother has a right to decide what shall happen in and to her body; everyone would grant that. But surely a person's right to life is stronger and more stringent than the mother's right to decide what happens in and to her body, and so outweighs it. So the fetus may not be killed; an abortion may not be performed.
It sounds plausible. but now let me ask you to imagine this. You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers {49} has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist's circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, "Look, we're sorry the Society of Music Lovers did this to you—we would never have permitted it if we had known. But still, they did it, and the violinist is now plugged into you. To unplug you would be to kill him. But never mind, it's only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you." Is it morally incumbent on you to accede to this situation? No doubt it would be very nice of you if you did, a great kindness. But do you have to accede to it? What if it were not nine months, but nine years? Or longer still? What if the director of the hospital says, "Tough luck, I agree, but you've now got to stay in bed, with the violinist plugged into you, for the rest of your life. Because remember this. All persons have a right to life, and violinists are persons. Granted you have a right to decide what happens in and to your body, but a person's right to life outweighs your right to decide what happens in and to your body. So you cannot ever be unplugged from him." I imagine you would regard this as outrageous, which suggests that something really is wrong with that plausible-sounding argument I mentioned a moment ago.
In this case, of course, you were kidnapped; you didn't volunteer for the operation that plugged the violinist into your kidneys. Can those who oppose abortion on the ground I mentioned make an exception for a pregnancy due to rape? Certainly. They can say that persons have a right to life only if they didn't come into existence because of rape; or they can say that all persons have a right to life, but that some have less of a right to life than others, in particular, that those who came into existence because of rape have less. But these statements have a rather unpleasant sound. Surely the question of whether you have a right to life at all, or how much of it you have, shouldn't turn on the question of whether or not you are the product of a rape. And in fact the people who oppose abortion on the ground I mentioned do not make this distinction, and hence do not make an exception in case of rape. {50}
Nor do they make an exception for a case in which the mother has to spend the nine months of her pregnancy in bed. They would agree that would be a pity, and hard on the mother; but all the same, all persons have a right to life, the fetus is a person, and so on. I suspect, in fact, that they would not make an exception for a case in which, miraculously enough, the pregnancy went on for nine years, or even the rest of the mother's life.
Some won't even make an exception for a case in which continuation of the pregnancy is likely to shorten the mother's life; they regard abortion as impermissible even to save the mother's life. Such cases are nowadays very rare, and many opponents of abortion do not accept this extreme view. All the same, it is a good place to begin: a number of points of interest come out in respect to it.
1. Let us call the view that abortion is impermissible even to save the mother's life "the extreme view." I want to suggest first that it does not issue from the argument I mentioned earlier without the addition of some fairly powerful premises. Suppose a woman has become pregnant, and now learns that she has a cardiac condition such that she will die if she carries the baby to term. What may be done for her? The fetus, being a person, has a right to life, but as the mother is a person too, so has she a right to life. Presumably they have an equal right to life. How is it supposed to come out that an abortion may not be performed? If mother and child have an equal right to life, shouldn't we perhaps flip a coin? Or should we add to the mother's right to life her right to decide what happens in and to her body, which everybody seems to be ready to grant—the sum of her rights now outweighing the fetus' right to life?
The most familiar argument here is the following. We are told that performing the abortion would be directly killing3 the child, whereas doing nothing would not be killing the mother, but only letting her die. Moreover, in killing the child, one would be killing an innocent person, for the child has committed no crime, and is not aiming at his mother's death. And then there are a variety of ways in which this {51} might be continued. (1) But as directly killing an innocent person is always and absolutely impermissible, an abortion may not be performed. Or, (2) as directly killing an innocent person is murder, and murder is always and absolutely impermissible, an abortion may not be performed.4 Or (3) as one's duty to refrain from directly killing an innocent person is more stringent than one's duty to keep a person from dying, an abortion may not be performed. Or, (4) if one's only options are directly killing an innocent person or letting a person die, one must prefer letting the person die, and thus an abortion may not be performed.5
Some people seem to have thought that these are not further premises which must be added if the conclusion is to be reached, but that they follow from the very fact that an innocent person has a right to life.6 But this seems to me to be a mistake, and perhaps the simplest way to show this is to bring out that while we must certainly grant that innocent persons have a right to life, the theses in (1) through (4) are all false. Take (2), for example. If directly killing an innocent person is murder, and thus impermissible, then the mother's directly killing the innocent person inside her is murder, and thus is {52} impermissible. But it cannot seriously be thought to be murder if the mother performs an abortion on herself to save her life. It cannot seriously be said that she must refrain, that she must sit passively by and wait for her death. Let us look again at the case of you and the violinist. There you are, in bed with the violinist, and the director of the hospital says to you, "It's all most distressing, and I deeply sympathize, but you see this is putting an additional strain on your kidneys, and you'll be dead within the month. But you have to stay where you are all the same. Because unplugging you would be directly killing an innocent violinist, and that's murder, and that's impermissible." If anything in the world is true, it is that you do not commit murder, you do not do what is impermissible, if you reach around to your back and unplug yourself from that violinist to save your life.
The main focus of attention in writings on abortion has been on what a third party may or may not do in answer to a request from a woman for an abortion. This is in a way understandable. Things being as they are, there isn't much a woman can safely do to abort herself. So the question asked is what a third party may do, and what the mother may do, if it is mentioned at all, is deduced, almost as an afterthought, from what it is concluded that third parties may do. But it seems to me that to treat the matter in this way is to refuse to grant to the mother that very status of person which is so firmly insisted on for the fetus. For we cannot simply read off what a person may do from what a third party may do. Suppose you find yourself trapped in a tiny house with a growing child. I mean a very tiny house, and a rapidly growing child—you are already up against the wall of the house and in a few minutes you'll be crushed to death. The child on the other hand won't be crushed to death; if nothing is done to stop him from growing he'll be hurt, but in the end he'll simply burst open the house and walk out a free man. Now I could well understand it if a bystander were to say, "There's nothing we can do for you. We cannot choose between your life and his, we cannot be the ones to decide who is to live, we cannot intervene." But it cannot be concluded that you too can do nothing, that you cannot attack it to save your life. However innocent the child may be, you do not have to wait passively while it crushes you to death. Perhaps a pregnant woman is vaguely felt to have the status of house, to which we don't allow the {53} right of self defense. But if the woman houses the child, it should be remembered that she is a person who houses it.
I should perhaps stop to say explicitly that I am not claiming that people have a right to do anything whatever to save their lives. I think, rather, that there are drastic limits to the right of self-defense. If someone threatens you with death unless you torture someone else to death, I think you have not the right, even to save your life, to do so. But the case under consideration here is very different. In our case there are only two people involved, one whose life is threatened, and one who threatens it. Both are innocent: the one who is threatened is not threatened because of any fault, the one who threatens does not threaten because of any fault. For this reason we may feel that we bystanders cannot intervene. But the person threatened can.
In sum, a woman surely can defend her life against the threat to it posed by the unborn child, even if doing so involves its death. And this shows not merely that the theses in (1) through (4) are false; it shows also that the extreme view of abortion is false, and so we need not canvass any other possible ways of arriving at it from the argument I mentioned at the outset.
2. The extreme view could of course be weakened to say that while abortion is permissible to save the mother's life, it may not be performed by a third party, but only by the mother herself. But this cannot be right either. For what we have to keep in mind is that the mother and the unborn child are not like two tenants in a small house which has, by an unfortunate mistake, been rented to both: the mother owns the house. The fact that she does adds to the offensiveness of deducing that the mother can do nothing from the supposition that third parties can do nothing. But it does more than this: it casts a bright light on the supposition that third parties can do nothing. Certainly it lets us see that a third party who cays "I cannot choose between you" is fooling himself if he things this is impartiality. If Jones has found and fastened on a certain coat, which he needs to keep him from freezing, but which Smith also needs to keep him from freezing, then it is not impartiality that says "I cannot choose between you" when Smith owns the coat. Women have said again and again "This body is my body!" and they have reason to feel angry, reason to feel that it has been like shouting into the wind. Smith, after all, is {54} hardly likely to bless us if we say to him, "Of course it's your coat, anybody would grant that it is. But no one may choose between you and Jones who is to have it."
We should really ask what it is that says "no one may choose" in the face of the fact that the body that houses the child is the mother's body. It may be simply a failure to appreciate this fact. But it may be something more interesting, namely the sense that one has a right to refuse to lay hands on people, even where it would be just and fair to do so, even where justice seems to require that somebody do so. Thus justice might call for somebody to get Smith's coat back from Jones, and yet you have a right to refuse to be the one to lay hands on Jones, a right to refuse to do physical violence to him. This, I think, must be granted. But then what should be said is not "no one may choose," but only "I cannot choose," and indeed not even this, but "I will not act," leaving it open that somebody else can or should, and in particular that anyone in a position of authority, with the job of securing people's rights, both can and should. So this is no difficulty. I have not been arguing that any given third party must accede to the mother's request that he perform an abortion to save her life, but only that he may.
I suppose that in some views of human life the mother's body is only on loan to her, the loan not being one which gives her any prior claim to it. One who held this view might well think it impartiality to say "I cannot choose." But I shall simply ignore this possibility. My own view is that if a human being has any just, prior claim to anything at all, he has a just, prior claim to his own body. And perhaps this needn't be argued for here anyway, since, as I mentioned, the arguments against abortion we are looking at do grant that the woman has a right to decide what happens in and to her body.
But although they do grant it, I have tired to show that they do not take seriously what is done in granting it. I suggest the same thing will reappear even more clearly when we turn away from cases in which the mother's life is at stake, and attend, as I propose we now do, to the vastly more common cases in which a woman wants an abortion for some less weighty reason than preserving her own life.
3. Where the mother's life is not at stake, the argument I mentioned at the outset seems to have a much stronger pull. "Everyone {55} has a right to life, so the unborn person has a right to life." And isn't the child's right to life weightier than anything other than the mother's own right to life, which she might put forward as ground for an abortion?
This argument treats the right to life as if it were unproblematic. It is not, as this seems to me to be precisely the source of the mistake.
For we should now, at long last, ask what it comes to, to have a right to life. In some views having a right to life includes having a right to be given at least the bare minimum one needs for continued life. But suppose that what in fact is the bare minimum a man needs for continued life is something he has no right at all to be given? If I am sick unto death, and the only thing that will save my life is the touch of Henry Fonda's cool hand on my fevered brow, then all the same, I have no right to be given the touch of Henry Fonda's cool hand on my fevered brow. It would be frightfully nice of him to fly in from the West Coast to provide it. It would be less nice, though no doubt well meant, if my friends flew out to the West Coast and carried Henry Fonda back with them. But I have no right at all against anybody that he should do this for me. Or again, to return to the story I told earlier, the fact that for continued life that violinist needs the continued use of your kidneys does not establish that he has a right to be given the continued use of your kidneys. He certainly has no right against you that you should give him continued use of your kidneys. For nobody has any right to use your kidneys unless you give him such a right; and nobody has the right against you that you shall give him this right—if you do allow him to go on using your kidneys, this is a kindness on your part, and not something he can claim from you as his due. Nor has he any right against anybody else that they should give him continued use of your kidneys. Certainly he had no right against the Society of Music Lovers that they should plug him into you in the first place. And if you now start to unplug yourself, having learned that you will otherwise have to spend nine years in bed with him, there is nobody in the world who must try to prevent you, in order to see that he is given something he has a right to be given.
Some people are rather stricter about the right to life. In their view, it does not include the right to be given anything, but amounts to, {56} and only to, the right not to be killed by anybody. But here a related difficulty arises. If everybody is to refrain from killing that violinist, then everybody must refrain from doing a great many different sorts of things. Everybody must refrain from slitting his throat, everybody must refrain from shooting him—and everybody must refrain from unplugging you from him. But does he have a right against everybody that they shall refrain from unplugging you from him? To refrain from doing this is to allow him to continue to use your kidneys. It could be argued that he has a right against us that we should allow him to continue to use your kidneys. That is, while he had no right against us that we should give him the use of your kidneys, it might be argued that he anyway has a right against us that we shall not now intervene and deprive him of the use of your kidneys. I shall come back to third-party interventions later. But certainly the violinist has no right against you that you shall allow him to continue to use your kidneys. As I said, if you do allow him to use them, it is a kindess on your part, and not something you owe him.
The difficulty I point to here is not peculiar to the right to life. It reappears in connection with all other natural rights; and it is something which an adequate account of rights must deal with. For present purposes it is enough just to draw attention to it. But I would stress that I am not arguing that people do not have a right to life—quite to the contrary, it seems to me that the primary control we must place on the acceptability of an account of rights is that it should turn out in that account to be a truth that all persons have a right to life. I am arguing only that having a right to life does not guarantee having either a right to be given the use of or a right to be allowed continued use of another person's body—even if one needs it for life itself. So the right to life will not serve the opponents of abortion in the very simple and clear way in which they seem to have thought it would.
4. There is another way to bring out the difficulty. In the most ordinary sort of case, to deprive someone of what he has a right to is to treat him unjustly. Suppose a boy and his small brother are jointly given a box of chocolates for Christmas. If the older boy takes the box and refuses to give his brother any of the chocolates, he is unjust to him, for the brother has been given a right to half of them. But {57} suppose that, having learned that otherwise it means nine years in bed with that violinist, you unplug yourself from him. You surely are not being unjust to him, for you gave him no right to use your kidneys, and no one else can have given him any such right. But we have to notice that in unplugging yourself, you are killing him; and violinists, like everybody else, have a right to life, and thus in the view we were considering just now, the right not to be killed. So here you do what he supposedly has a right you shall not do, but you do not act unjustly to him in doing it.
The emendation which may be made at this point is this: the right to life consists not in the right not to be killed, but rather in the right not to be killed unjustly. This runs a risk of circularity, but never mind: it would enable us to square the fact that the violinist has a right to life with the fact that you do not act unjustly toward him in unplugging yourself, thereby killing him. For if you do not kill him unjustly, you do not violate his right to life, and so it is no wonder you do him no injustice.
But if this emendation is accepted, the gap in the argument against abortion stares us plainly in the face: it is by no means enough to show that the fetus is a person, and to remind us that all persons have a right to life—we need to be shown also that killing the fetus violates its right to life, i.e., that abortion is unjust killing. And is it?
I suppose we may take it as a datum that in a case of pregnancy due to rape the mother has not given the unborn person a right to the use of her body for food and shelter. Indeed, in what pregnancy could it be supposed that the mother has given the unborn person such a right? It is not as if there were unborn persons drifting about the world, to whom a woman who wants a child says "I invite you in."
But it might be argued that there are other ways one can have acquired a right to the use of another person's body than by having been invited to use it by that person. Suppose a woman voluntarily indulges in intercourse, knowing of the chance it will issue in pregnancy, and then she does become pregnant; is she not in part responsible for the presence, in fact the very existence, of the unborn person inside her? No doubt she did not invite it in. But doesn't her partial responsibility for its being there itself give it a right to the use of her {58} body?7 If so, then her aborting it would be more like the boy's taking away the chocolates, and less like your unplugging yourself from the violinist—doing so would be depriving it of what it does have a right to, and thus would be doing it an injustice.
And then, too, it might be asked whether or not she can kill it even to save her own life: if she voluntarily called it into existence, how can she now kill it, even in self-defense?
The first thing to be said about this is that it is something new. Opponents of abortion have been so concerned to make out the independence of the fetus, in order to establish that it has a right to life, just as its mother does, that they have tended to overlook the possible support they might gain from making out that the fetus is dependent on the mother, in order to establish that she has a special kind of responsibility for it, a responsibility that gives it rights against her which are not possessed by any independent person—such as an ailing violinist who is a stranger to her.
On the other hand, this argument would give the unborn person a right to its mother's body only if her pregnancy resulted from a voluntary act, undertaken in full knowledge of the chance a pregnancy might result from it. It would leave out entirely the unborn person whose existence is due to rape. Pending the availability of some further argument, then, we would be left with the conclusion that unborn persons whose existence is due to rape have no right to the use of their mothers' bodies, and thus that aborting them is not depriving them of anything they have a right to and hence is not unjust killing.
And we should also notice that it is not at all plain that this argument really does go even as far as it purports to. For there are cases and cases, and the details make a difference. If the room is stuffy, and I therefore open a window to air it, and a burglar climbs in, it would it be absurd to say, "Ah, now he can stay, she's given him a right to the use of her house—for she is partially responsible for his presence there, having voluntarily done what enabled him to get in, in full knowledge that there are such things as burglars, and that burglars {59} burgle." It would be still more absurd to say this if I had had bars installed outside my windows, precisely to prevent burglars from getting in, and a burglar got in only because of a defect in the bars. It remains equally absurd if we imagine it is not a burglar who climbs in, but an innocent person who blunders or falls in. Again, suppose it were like this: people-seeds drift about in the air like pollen, and if you open your windows, one may drift in and take root in your carpets or upholstery. You don't want children, so you fix up your windows with fine mesh screens, the very best you can buy. As it happens, however, and on very, very rare occasions does happen, one of the screens is defective; and a seed drifts in and takes root. Does the person-plant who now develops have a right to the use of your house? Surely not—despite the fact that you voluntarily opened your windows, you knowingly kept carpets and upholstered furniture, and you knew that screens were sometimes defective. Someone may argue that you are responsible for its rooting, that it does have a right to your house, because after all you could have lived out your life with bare floors and furniture, or with sealed windows and doors. But this won't do—for by the same token anyone can avoid pregnancy due to rape by having a hysterectomy, or anyway by never leaving home without a (reliable!) army.
It seems to me that the argument we are looking at can establish at most that there are some cases in which the unborn person has a right to the use of its mother's body, and therefore some cases in which abortion is unjust killing. There is room for much discussion and argument as to precisely which, if any. But I think we should sidestep this issue and leave it open, for at any rate the argument certainly does not establish that all abortion is unjust killing.
5. There is room for yet another argument here, however. We surely must grant that there may be cases in which it would be morally indecent to detach a person from your body at the cost of his life. Suppose you learn that what the violinist needs is not nine years of your life, but only one hour: all you need do to save his life is to spend one hour in that bed with him. Suppose also that letting him use your kidneys for that one hour would not affect your health in the slightest. Admittedly you were kidnapped. Admittedly you did not give {60} anyone permission to plug him into you. Nevertheless it seems to me plain you ought to allow him to use your kidneys for that hour—it would be indecent to refuse.
Again, suppose pregnancy lasted only an hour, and constituted no threat to life or health. And suppose that a woman becomes pregnant as a result of rape. Admittedly she did not voluntarily do anything to bring about the existence of a child. Admittedly she did nothing at all which would give the unborn person a right to the use of her body. All the same it might well be said, as in the newly emended violinist story, that she ought to allow it to remain for that hour—that it would be indecent in her to refuse.
Now some people are inclined to use the term "right" in such a way that it follows from the fact that you ought to allow a person to use your body for the hour he needs, that he has a right to use your body for the hour he needs, even though he has not been given that right by any person or act. They may say that it follows also that if you refuse, you act unjustly toward him. This use of the term is perhaps so common that it cannot be called wrong; nevertheless it seems to me to be an unfortunate loosening of what we would do better to keep a tight rein on. Suppose that box of chocolates I mentioned earlier had not been given to both boys jointly, but was given only to the older boy. There he sits, stolidly eating his way through the box, his small brother watching enviously. Here we are likely to say "You ought not to be so mean. You ought to give your brother some of those chocolates." My own view is that it just does not follow from the truth of this that the brother has any right to any of the chocolates. If the boy refuses to give his brother any, he is greedy, stingy, callous—but not unjust. I suppose that the people I have in mind will say it does follow that the brother has a right to some of the chocolates, and thus that the boy does act unjustly if he refuses to give his brother any. But the effect of saying this is to obscure what we should keep distinct, namely the difference between the boy's refusal in this case and the boy's refusal in the earlier case, in which the box was given to both boys jointly, and in which the small brother thus had what was from any point of view clear title to half.
A further objection to so using the term "right" that from the fact that A ought to do a thing for B, it follows that B has a right against A {61} that A do it for him, is that it is going to make the question of whether or not a man has a right to a thing turn on how easy it is to provide him with it; and this seems not merely unfortunate, but morally unacceptable. Take the case of Henry Fonda again. I said earlier that I had no right to the touch of his cool hand on my fevered brow, even though I needed it to save my life. I said it would be frightfully nice of him to fly in from the West Coast to provide me with it, but that I had no right against him that he should do so. But suppose he isn't on the West Coast. Suppose he has only to walk across the room, place a hand briefly on my brow—and lo, my life is saved. Then surely he ought to do it, it would be indecent to refuse. Is it to be said "Ah, well, it follows that in this case she has a right to the touch of his hand on her brow, and so it would be an injustice in him to refuse"? So that I have a right to it when it is easy for him to provide it, though no right when it's hard? It's rather a shocking idea that anyone's rights should fade away and disappear as it gets harder and harder to accord them to him.
So my own view is that even though you ought to let the violinist use your kidneys for the one hour he needs, we should not conclude that he has a right to do so—we should say that if you refuse, you are, like the boy who owns all the chocolates and will give none away, self-centered and callous, indecent in fact, but not unjust. And similarly, that even supposing a case in which a woman pregnant due to rape ought to allow the unborn person to use her body for the hour he needs, we should not conclude that he has a right to do so; we should conclude that she is self-centered, callous, indecent, but not unjust, if she refuses. The complaints are no less grave, they are just different. However, there is no need to insist on this point. If anyone does wish to deduce "he has a right" from "you ought," then all the same he must surely grant that there are cases in which it is not morally required of you that you allow that violinist to use your kidneys, and in which he does not have a right to use them, and in which you do not do him an injustice if you refuse. And so also for mother and unborn child. Except in such cases as the unborn person has a right to demand it—and we were leaving open the possibility that there may be such cases—nobody is morally required to make large sacrifices, of health, of all other interests and concerns, of all other duties {62} and commitments, for nine years, or even for nine months, in order to keep another person alive.
6. We have in fact to distinguish between two kinds of Samaritan: the Good Samaritan and what we might call the Minimally Decent Samaritan. The story of the Good Samaritan, you will remember, goes like this:
A certain man went down from
And by chance there came down a certain priest that way; and when he saw him, he passed by on the other side.
And likewise a Levite, when he was at the place, came and looked on him, and passed by on the other side.
But a certain Samaritan, as he journeyed, came where he was; and when he saw him he had compassion on him.
And went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, and brought him to an inn, and took care of him.
And on the morrow, when he departed, he took out two pence, and gave them to the host, and said unto him, "Take care of him; and whatsoever thou spendest more, when I come again, I will repay thee." (Luke 10:30-35)
The Good Samaritan went out of his way, at some cost to himself, to help one in need of it. We are not told what the options were, that is, whether or not the priest and the Levite could have helped by doing less than the Good Samaritan did, but assuming they could have, then the fact they did nothing at all shows they were not even Minimally Decent Samaritans, not because they were not Samaritans, but because they were not even minimally decent.
These things are a matter of degree, of course, but there is a difference, and it comes out perhaps most clearly in the story of Kitty Genovese, who, as you will remember, was murdered while thirty-eight people watched or listened, and did nothing at all to help her. A Good Samaritan would have rushed out to give direct assistance {63} against the murderer. Or perhaps we had better allow that it would have been a Splendid Samaritan who did this, on the ground that it would have involved a risk of death for himself. But the thirty-eight not only did not do this, they did not even trouble to pick up a phone to call the police. Minimally Decent Samaritanism would call for doing at least that, and their not having done it was monstrous.
After telling the story of the Good Samaritan, Jesus said "Go, and do thou likewise." Perhaps he meant that we are morally required to act as the Good Samaritan did. Perhaps he was urging people to do more than is morally required of them. At all events it seems plain that it was not morally required of any of the thirty-eight that he rush out to give direct assistance at the risk of his own life, and that it is not morally required of anyone that he give long stretches of his life—nine years or nine months—to sustaining the life of a person who has no special right (we are leaving open the possibility of this) to demand it.
Indeed, with one rather striking class of exceptions, no one in any country in the world is legally required to do anywhere near as much as this for anyone else. The class of exceptions is obvious. My main concern here is not the sate of the law in respect to abortion, but it is worth drawing attention to the fact that in no state in this country is any man compelled by law to be even a Minimally Decent Samaritan to any person; there is no law under which charges could be brought against the thirty-eight who stood by while Kitty Genovese died. By contrast, in most states in this country women are compelled by law to be not merely Minimally Decent Samaritans, but Good Samaritans to unborn persons inside them. This doesn't by itself settle anything one way or the other, because it may well be argued that there should be laws in this country—as there are in many European countries—compelling at least Minimally Decent Samaritanism.8 But it does show that there is a gross injustice in the existing state of the law. And it shows also that the groups currently working against liberalization of abortion laws, in fact working toward having it declared unconstitu-{64}tional for a state to permit abortion, had better start working for the adoption of Good Samaritan laws generally, or earn the charge that they are acting in bad faith.
I should think, myself, that Minimally Decent Samaritan laws would be one thing, Good Samaritan laws quite another, and in fact highly improper. But we are not here concerned with the law. What we should ask is not whether anybody should be compelled by law to be a Good Samaritan, but whether we must accede to a situation in which somebody is being compelled—by nature, perhaps—to be a Good Samaritan. We have, in other words, to look now at third-party interventions. I have been arguing that no person is morally required to make large sacrifices to sustain the life of another who has no right to demand them, and this even where the sacrifices do not include life itself; we are not morally required to be Good Samaritans or anyway Very Good Samaritans to one another. But what if a man cannot extricate himself from such a situation? What if he appeals to us to extricate him? It seems to me plain that there are cases in which we can, cases in which a Good Samaritan would extricate him. There you are, you were kidnapped, and nine years in bed with that violinist lie ahead of you. You have your own life to lead. You are sorry, but you simply cannot see giving up so much of your life to the sustaining of his. You cannot extricate yourself, and ask us to do so. I should have thought that—in light of his having no right to the use of your body—it was obvious that we do not have to accede to your being forced to give up so much. We can do what you ask. There is no injustice to the violinist in our doing so.
7. Following the lead of the opponents of abortion, I have throughout been speaking of the fetus merely as a person, and what I have been asking is whether or not the argument we began with, which proceeds only from the fetus being a person, really does establish its conclusion. I have argued that it does not.
But of course there are arguments and arguments, and it may be said that I have simply fastened on the wrong one. It may be said that what is important is not merely the fact that the fetus is a person, but that it is a person for whom the woman has a special kind of responsibility issuing from the fact that she is its mother. And it might be argued that all my analogies are therefore irrelevant—for you do {65} not have that special kind of responsibility for that violinist, Henry Fonda does not have that special kind of responsibility for me. And our attention might be drawn to the fact that men and women both are compelled by law to provide support for their children.
I have in effect dealt (briefly) with this argument in section 4 above; but a (still briefer) recapitulation now may be in order. Surely we do not have any such "special responsibility" for a person unless we have assumed it, explicitly or implicitly. If a set of parents do not try to prevent pregnancy, do not obtain an abortion, and then at the time of birth of the child do not put it out for adoption, but rather take it home with them, then they have assumed responsibility for it, they have given it rights, and they cannot now withdraw support from it at the cost of its life because they now find it difficult to go on providing for it. But if they have taken all reasonable precautions against having a child, they do not simply by virtue of their biological relationship to the child who comes into existence have a special responsibility for it. They may wish to assume responsibility for it, or they may not wish to. And I am suggesting that if assuming responsibility for it would require large sacrifices, then they may refuse. A Good Samaritan would not refuse—or anyway, a Splendid Samaritan, if the sacrifices that had to be made were enormous. But then so would a Good Samaritan assume responsibility for that violinist; so would Henry Fonda, if he is a Good Samaritan, fly in from the West Coast and assume responsibility for me.
8. My argument will be found unsatisfactory on two counts by many of those who want to regard abortion as morally permissible. First, while I do argue that abortion is not impermissible, I do not argue that it is always permissible. There may well be cases in which carrying the child to term requires only Minimally Decent Samaritanism of the mother, and this is a standard we must not fall below. I am inclined to think it a merit of my account precisely that it does not give a general yes or a general no. It allows for and supports our sense that, for example, a sick and desperately frightened fourteen-year-old schoolgirl, pregnant due to rape, may of course choose abortion, and that any law which rules this out is an insane law. And it also allows for and supports our sense that in other cases resort to abortion is even positively indecent. It would be indecent in the woman to request an {66} abortion, and indecent in a doctor to perform it, if she is in her seventh month, and wants the abortion just to avoid the nuisance of postponing a trip abroad. The very fact that the arguments I have been drawing attention to treat all cases of abortion, or even all cases of abortion in which the mother's life is not at stake, as morally on a par ought to have made them suspect at the outset.
Secondly, while I am arguing for the permissibility of abortion in some cases, I am not arguing for the right to secure the death of the unborn child. It is easy to confuse these two things in that up to a certain point in the life of the fetus it is not able to survive outside the mother's body; hence removing it from her body guarantees its death. But they are importantly different. I have argued that you are not morally required to spend nine months in bed, sustaining the life of that violinist; but to say this is by no means to say that if, when you unplug yourself, there is a miracle and he survives, you then have a right to turn round and slit his throat. You may detach yourself even if this costs him his life; you have no right to be guaranteed his death, by some other means, if unplugging yourself does not kill him. There are some people who will feel dissatisfied by this feature of my argument. A woman may be utterly devastated by the thought of a child, a bit of herself, put out for adoption and never seen or heard of again. She may therefore want not merely that the child be detached from her, but more, that it die. Some opponents of abortion are inclined to regard this as beneath contempt—thereby showing insensitivity to what is surely a powerful source of despair. All the same, I agree that the desire for the child's death is not one which anybody may gratify, should it turn out to be possible to detach the child alive.
At this place, however, it should be remembered that we have only been pretending throughout that the fetus is a human being from the moment of conception. A very early abortion is surely not the killing of a person, and so is not dealt with by anything I have said here.
1. I am very much indebted to James Thomson for discussion, criticism, and many helpful suggestions.
2. Daniel Callahan, Abortion: Law, Choice, and Morality (New York, 1970), p. 373. This book gives a fascinating survey of the available information on abortion. The Jewish tradition is surveyed in David M. Feldman, Birth Control in Jewish Law (New York, 1968), Part 5, the Catholic tradition in John T. Noonan, Jr., "An Absolute Value in History," in The Morality of Abortion, ed. John T. Noonan, Jr. (Cambridge, Mass., 1970).
3. The term "direct" in the argument I refer to is a technical one. Roughly, what is meant by "direct killing" is either killing as an end in itself, or killing as a means to some end, for example, the end of saving someone else's life. See note 6, below, for an example of its use.
4. Cf. Encyclical Letter of Pope Pius XI on Christian Marriage, St. Paul Editions (Boston, n.d.), p. 32: "however much we may pity the mother whose health and even life is gravely imperiled in the performance of the duty allotted to her by nature, nevertheless what could ever be a sufficient reason for excusing in any way the direct murder of the innocent? This is precisely what we are dealing with here." Noonan (The Morality of Abortion, p. 43) reads this as follows: "What cause can ever avail to excuse in any way the direct killing of the innocent? For it is a question of that."
5. The thesis in (4) is in an interesting way weaker than those in (1), (2), and (3): they rule out abortion even in cases in which both the mother and child will die if the abortion is not performed. By contrast, one who held the view expressed in (4) could consistently say that one needn't prefer letting two persons die to killing one.
6. Cf. the following passage from Pius XII, Address to the Italian Catholic Society of Midwives: "The baby in the maternal breast has the right to life immediately from God.—Hence there is no man, no human authority, no science, no medical, eugenic, social, economic, or moral 'indication' which can establish or grant a valid juridical ground for a direct deliberate disposition of an innocent human life, that is a disposition which looks to its destruction either as an end or as a means to another end perhaps in itself not illicit.—The baby, still not born, is a man in the same degree and for the same reason as the mother" (quoted in Noonan, The Morality of Abortion, p. 45).
7. The need for a discussion of this argument was brought home to me by members of the Society for Ethical and Legal Philosophy, to whom this paper was originally presented.
8. For a discussion of the difficulties involved, and a survey of the European experience with such laws, see The Good Samaritan and the Law, ed. James M. Ratcliffe (New York, 1966).
From Philosophy and Public Affairs, Vol. 1, No. 1, p. 47 (1971)
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