Bioethics is a broad and expanding field of ethical inquiry into questions concerning human life, its beginning and end, and its interaction with medicine and other technologies. When I began my formal study of bioethics, I noticed that many issues were interrelated, and the issue which had perhaps the most implications for the resolution of any other was the question of abortion. For example, a pro-life disability ethic is able to recognize that ableism begins prenatally, which prompts measures to protect fetal humans from discrimination on the basis of disability. It occurred to me only recently that, in at least some cases of abortion, the parents believe that they are aborting the child for its own good. That is to say, while abortion is the method by which the fetus is killed, the parents are really looking at the question through the lens of euthanasia.
There are many reasons why parents (or society) may believe that it would be better for a child if he or she wasn’t born. Often, the reason is a medical condition. There are cases in which a child will not survive birth, or in which the child will have a very brief and painful postnatal life. Another issue is that of prenatal diagnosis of disabilities, in which people argue that the child’s quality of life would be so low that it is hardly worth living. At times, economic factors may come into play. At least in conversations on college campuses, the possibility of hardship by way of the foster system is a concern. A lot of these concerns are understandable; people want their children to avoid pain, on the whole, and to have happy lives. But the desire to avoid pain and promote happiness is a questionable justification for depriving someone of life.
These concerns about the quality of a fetal human’s life after birth animate two different lines of argument. I want to distinguish between how each argument functions and give a response to the primary issue underlying each one. In each case, I’m going to assume a scenario in which a child has a disease which lowers the chances of surviving through hospital discharge and which would likely cause the child to have some amount of pain for the rest of its life.
When Abortion is Still Abortion
In the first case, the parents are contemplating abortion because they want to spare the child lifelong pain. They do not view the fetus as a person, but as a potential person, which is to say something that has no rights or status but which will likely go on to become a rights-bearing person; in this case, the fetus goes from potential to actual person at birth. Because they view the fetus as a potential person, they do not believe that abortion is killing a person, but rather preventing a person from coming into being. Accordingly, aborting the fetus who is projected for a life of pain is preventing a person from coming into existence who will experience pain for their entire life.
In this scenario, the parents still have a mindset of abortion rather than euthanasia. The problem with their viewpoint is primarily that they do not recognize the personhood of unborn humans. If the fetus is a person, they would be killing an actual person to prevent them from experiencing future pain rather than merely preventing a person from coming into being. Here, we can trot out a toddler. If a two-year-old was diagnosed with a disease that would cause pain for the rest of her life, and which may drastically shorten her life, would we find it acceptable for her parents to kill her? If the hypothetical parents answer no for the toddler but yes for the fetus, than they have an incorrect view of fetal personhood (and you should probably tell them about the Equal Rights Argument). If the parents in the scenario say that yes, you should be able to kill the toddler to prevent her from experiencing pain, then you’re in a different scenario entirely.
Abortion as Euthanasia
In the second case, the parents can accept for the sake of argument that the fetal human is a person, sharing the human dignity that makes it worth protection. The parents do not want to get an abortion to prevent a person from coming into being with a painful life, but because they believe that it is more merciful to spare the child pain by killing it before it can experience continued pain. This issue is not primarily an issue of abortion; the parents in this case would also say that it was justified to kill the toddler. The taking of life has nothing to do with the location of the human, but rather with its prospects for a good life. Those who believe that it is sometimes better to seek out an early death by medical means support euthanasia. If you are in a conversation about abortion in cases of disease or genetic abnormality and the person to whom you’re speaking thinks it would be appropriate to kill a similarly situated toddler or newborn (or adult), you need to recognize that the conversation at that point is no longer about abortion.
People who advocate euthanasia have a powerful emotional argument in their favor. Euthanasia, they would say, is an act of mercy; by killing the person, you are preventing them from experiencing pain and protecting their autonomy in decision-making. Our desire to protect people from pain is so strong that people have even begun to extend the opportunity for euthanasia to minors who would not normally be able to give consent for any medical decisions. In fact, the Netherlands has had a practice in place for over 15 years, called the Gröningen Protocol, which (at first unofficially, then officially) allowed euthanizing newborns who were terminally ill or, as in our scenario above, likely to experience a life of pain.
Often, people who oppose euthanasia will argue on one of three grounds:
- People are created in the image of God, and killing a person who did not commit a crime is itself a crime against God;
- Euthanasia is a slippery slope, which means even if we thought euthanasia for consenting adults was acceptable, it would lead to unacceptable policies such as euthanasia for children or euthanizing people who are unable to give consent or against their will;
- We have the medical technology to control pain, so concerns about pain from a terminal illness are overblown and insufficient to justify taking human life.
The first argument is a religious one, and so it is unlikely to appeal to secular advocates of euthanasia, though should be used in conversations with pro-euthanasia Christians. The second argument has been borne out to some extent; the problem is, we don’t find those things unacceptable anymore, and even if we did the argument becomes one about whether regulating euthanasia will be effective rather than whether it is wrong on its face. The third argument is based on a questionable premise, especially given opioid-induced pain and addiction; but even if the premise were true, we would be attempting to give a moral problem a technological solution. All it would take to open the doors to euthanasia once again is for a disease to arise which was resistant to all known pain relievers.
How, then, should we respond to arguments in favor of euthanasia generally, and therefore to euthanasia by abortion specifically? I believe that the most important argument we can make is that, while pain is evil, it is not an ultimate evil. What I mean by that is that pain is not so bad that it takes away all of the value from an opposing good. Life is an intrinsic good, one that cannot be counterbalanced even by evil circumstances. Everyone experiences many kinds of pain in life, yet when people affected by pain attempt to end their own lives, we as a society intervene and prevent them from committing suicide. We think that people who attempt to kill themselves are not seeing their own situation accurately, and we prevent them from acting on their own choice in that moment.
To be more specific, when someone is contemplating suicide for mental health reasons, such as suffering from depression, we prevent them from killing themselves and consider them to be potentially incapable of making responsible medical decisions relevant to their condition. Someone may argue that emotional or mental pain isn’t the same as physical pain, from which it is more important to seek deliverance. Differentiating between these types of pain doesn’t really make sense, though; mental or emotional pain isn’t less painful because it isn’t physical, so preventing severely depressed people from committing suicide but allowing people in severe physical pain to undergo euthanasia essentially amounts to discrimination.
On the other hand, someone may argue that we should allow euthanasia for any cases of severe pain. This is a stronger argument because it’s logically consistent, but it leads to a low view of the value of life. My present pain may feel overwhelming and inescapable, but my estimation of my pain may not be accurate. My pain may subside, or I may adapt, or there might be a way out that I did not anticipate. In any of those situations, euthanasia during the moment of pain would have deprived me of the remaining value of my life for relief that could possibly have come anyway. But even in cases where the remaining life will be short and relief will not come, a pro-euthanasia mindset indicates that life is of merely contingent value, that pain is a greater evil than life is a good, and it calls into question why we bother going on with this whole project of living in the first place.
We affirm not only that the fetal human with a painful situation has a right to life, but that her life is valuable despite whatever difficulties she may face. Even in a situation in which the baby is predicted to have a short, painful life, her life is a good which should be protected and preserved as we are able to do so, even as we seek to reduce her pain. Furthermore, it should be noted that abortion is not a simple, non-violent way to prevent someone from experiencing pain. The reality of abortion is that of a brutal procedure in which a human is torn into pieces; even in cases where adult humans would be unable to experience pain, we would consider it barbaric to do such an action to them.
A Few Practical Applications
I’ve gone pretty quickly, and a lot of this may seem like heady stuff, so I want to finish on a more practical note. After all, you’re probably more interested in having good conversations with people about abortion than you are in writing a research paper on euthanasia.
#1: When talking about abortion in cases involving prenatal diagnoses, poverty, or similar quality-of-life issues, trot out a toddler to find out whether they’re in favor of abortion because they don’t believe the fetal human is a person or because they believe they’re doing a good thing by euthanizing the fetus the way they would another person.
#2: Pro-life people spend a lot of time talking about the right to life. When euthanasia and related ideas come into play, we also have to be prepared to talk about the value of life. Life, even in difficult circumstances, has value which is not outweighed by the pain of those circumstances.
#3: Recognize that the impulse for euthanasia is generally driven by a desire for mercy. Create common ground by emphasizing that you don’t want people to have to be in pain. Tell the person with whom you’re talking about the ways that do exist to alleviate pain, and explain the ways in which you support helping people through difficult situations.
#4: If beneficial, talk about the reality of the abortion procedure. Euthanasia has significant rhetorical capital in the idea of a quiet, painless death, but abortion is pretty far removed from that ideal, even if it takes place before the fetal human is capable of experiencing pain.
 To keep this article from being too long, I won’t talk at length here about the problems with the quality-of-life approach to medical decision-making, nor about the broader problems with a low view of people with disabilities, such as the fact that many people with disabilities live happy and meaningful lives, as well as sad and empty lives, just like everyone else.
 The autonomy argument isn’t relevant in this situation because a fetus, being under 18 years of age, has no medical autonomy to protect. It is the parents whose autonomy in decision-making would be at stake, but they are constrained to operate first by the standard of acting in the child’s best interests, and only secondarily to take into account quality-of-life concerns. The autonomy argument is intuitively powerful, because we want to have a say in our own lives, but it is problematic in that euthanasia destroys all future autonomy for the person who undergoes it.
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The post “When Is Abortion Fetal Euthanasia In Disguise?” originally appeared at the Equal Rights Institute blog. Subscribe to our email list with the form below and get a FREE gift. Click here to learn more about our pro-life apologetics course, “Equipped for Life: A Fresh Approach to Conversations About Abortion.”