I’m excited to share with you an actual email exchange I’ve been having with a very thoughtful pro-choice person named Chloe, with her permission. The conversation is ongoing, so we’ll continue to add to this post as the exchange continues. The content has only been lightly edited for clarity, and Chloe has had the chance to remove any personal information from the posts. Other than that, you’re seeing the full exchange. Thanks to Andrew and Emily who have helped edit my responses during the exchange.

Estimated reading time: 25 minutes

It all started when my friend Isaac Saul from the fantastic Tangle newsletter reached out to me with a question from Chloe, one of his pro-choice readers. In case you haven’t heard me talk about Tangle yet, it’s a free daily e-newsletter from Monday to Thursday (with a subscription option for special Friday editions) that explores the main topic being discussed in DC that day, a fair summary of what people on the left and right are saying about it, and then Isaac’s take. I find him very fair-minded and often agree with his conclusions. Even when I don’t, that’s okay too! That’s the point of avoiding confirmation bias: exposing yourself to the things that thoughtful people on the other side are saying, in case you find that you should change your mind. (You might also find new or better reasons for maintaining your original view!) I think Isaac Saul is a fascinating person, and you can learn more about him by listening to this episode of our podcast where I interviewed him.

His recent email to me after covering the Dobbs Supreme Court case included:

One reader recently posed a question to me that I did not know the answer to. I think, because my views are most easily described as pro-choice, I simply saw the effectiveness of her question and “agreed” with where it was leading. So, instead of answering it in the newsletter, I wanted to ask if you would? Maybe as a guest respondent in Tangle?

Anyway, here is the question: 

Suppose you have a heterosexual couple. They have one very young child, and that child has fallen mortally ill. There is a medical procedure that may save the child’s life, but it requires the participation of one of the parents. The child will definitely die if they do not undergo the procedure.

The parameters can, of course, be varied to more closely parallel various situations that can occur as a result of pregnancy, e.g. the procedure takes months, has negative effects during and/or after completion, may kill the adult, will definitely kill the adult – and so on. Can we morally, ethically, and/or legally force either parent to participate in the procedure? If not, then how is the case of abortion different? If so, then can we force people to give up blood, organs, tissue, etc. to sick people?

My Response:

This is a great question and highlights something I’ve noticed in my conversations with pro-choice people for the last decade, which is that they aren’t primarily pro-choice because they believe the fetal human isn’t a person. They are primarily pro-choice because they believe the government shouldn’t tell a woman what to do with her body, or something in her body, even if that thing IS a person. The first and most famous version of the hypothetical story in the reader question is Judith Jarvis Thomson’s violinist thought experiment. The way these arguments work is that they concede (for sake of argument) fetal personhood, and argue that a woman should have the right to an abortion even if the unborn is a person. For that reason, I’ll refer to the unborn as persons for the sake of this answer, but I know that if the unborn are not persons, then abortion should be legal. For more on a secular defense of fetal personhood, check out our article, Arguing From Equality: The Personhood of Human Embryos.

The short answer is that no, I do not believe that in this thought experiment we should force parents to participate in the procedure. This might sound surprising since I do believe that abortion should be illegal unless the mother’s life is at risk. So what’s the morally relevant difference between these two cases then? There are a few different differences that pro-life people often point out, but the most important one is the distinction between not helping someone and directly killing them. 

I think there’s a very understandable reason that many people are pro-choice, which is that they are thinking of pregnancy being like most other cases where we can either choose to help someone or not. 

For example, if my friend Isaac Saul was dying of kidney failure and asked me to donate one of my kidneys to him, I hypothetically have three options:

1. I can choose to help him, by donating my kidney;
2. I can choose to not help him, by keeping both kidneys;
3. I could directly kill him, say, to spare myself the embarrassment of refusing his request.

Those are three distinct options. However, I think it’s pretty obvious that the third option—directly killing Isaac —shouldn’t be a legal option for me. So, that leaves me with two legal options: help or not help. 

But in the case of pregnancy, you only have two options to start with: 

1. You can either help, by carrying the pregnancy to term, or at least until the fetal person is viable;
2. You can hire a doctor to directly kill the fetal person through an abortion.

There is no third option. The option just to “not help” doesn’t exist!

This is one of the main problems with Thomson’s famous violinist thought experiment: it pretends that abortion is merely unplugging from a sick person or choosing not to help them. But that’s not how abortion works. It directly kills a (typically) healthy person.

Abortion is more like this thought experiment: Imagine you take your medium-sized boat out for a pleasure ride. You’re hours from shore before realizing that there’s a six-year-old boy hiding in your closet! He was playing hide and seek at the dock and stupidly got on a stranger’s boat. 

In this case, you only have two options:

1: You can either help, by allowing the child to be on your boat until you take it back to shore and you can deliver him to the authorities;

2: You can kill him, by tossing him overboard.

There is no “don’t help” option here, just like pregnancy.

I do not believe that we should legally force people to help others, especially if it would put yourself in danger, outside of fairly narrow cases. (For example, lifeguards have a special duty to help as a result of their job.) But I do believe that we should never be allowed to directly kill people, outside of very extreme cases like self-defense. If I’m right about that, then you can’t kill the six-year-old in the boat story, even though that only leaves you with one option: help. I think the same is true in pregnancy; if help and kill are the only options available, and I think killing should always be illegal except for in self-defense, then I think that abortion has to be wrong, too. I don’t think that we should have an obligation to always help innocent, vulnerable people, but I do think we have an obligation not to kill innocent, vulnerable people. 

Sometimes the distinction between “not helping” and “killing” can seem confusing, so to put it another way, I think we have an obligation to not make people worse off than they already are. I don’t think that we can purposefully make a person “unhealthy” by tossing them overboard, putting them in an inhospitable environment, or otherwise killing them directly. Hypothetical stories like Thompson’s thought experiment and the reader question posed here always use an already unhealthy, dying person and claim that we shouldn’t have a legal obligation to save or help them. I don’t disagree with that! The problem is that the fetus is different. The fetus isn’t an unhealthy, dying person who you’re refusing service to. The fetus is a healthy person you’re killing.

By the way, this is probably why there’s a new trend for pro-choice people to call abortion an act of self-defense. This is a super interesting direction, and I don’t have the space to fully respond to it here, but I am not convinced that abortions are an act of self-defense if the mother’s life is not at risk. Pro-choice people want to argue that any pregnancy COULD become life-threatening, so even early abortions are acts of self-defense. But to say that killing another innocent person is justified by self-defense, there needs to be some sort of legitimate risk to your life and probably there needs to be no other safe alternatives. How do we determine what constitutes a legitimate risk to your life? Should you need to know it is a 50/50 chance that you will live or die? Maybe a 10% likelihood of death? Our intuitions might vary on where the line should be and it probably depends on other factors as well. That exact line might move case by case and I don’t think we need to answer this question before we decide whether or not abortion can be considered self-defense, because the risk to the woman’s life that pregnancy poses doesn’t even come close to reasonable. It isn’t even a 1% risk. In the United States in 2016, a pregnant woman had a 0.017% chance of dying because of a pregnancy-related complication. You actually have a higher risk of death from getting your appendix removed, which is 0.21% chance for patients under 60 years old.

Like many people, I fully support non-violent efforts to reduce maternal mortality. I don’t want any women to die from childbirth, even if it is a low risk. And of course developing nations have a higher risk of maternal mortality than the United States. Let’s look at Ghana as an example because it is one of the most dangerous places to give birth in the world. In 2017, the maternal mortality rate in Ghana was 0.31%. How much should your life be at risk for you to call it self-defense to kill another person? My answer is at least higher than 1%.

For more responses to this category of pro-choice arguments, read our piece, Refuting “Abortion as Self-Defense”.

In summary, I don’t think that we should force people to donate their organs to other people, even if, as in the story the reader question suggested, the person needing your assistance is your own child. I don’t think that people should have a legal obligation to help others, but I do think we should have a legal obligation not to directly kill others. So if killing and helping are the only available options in pregnancy, then I think abortion has to be wrong.

Chloe’s Response:

Your point about abortion being a proactive choice to end a life, rather than a passive action that results in the life ending, is a good one. I am also, personally, not a fan of the violinist hypothetical, outside of the clear influence it had on the hypothetical I put forward. But I have more thoughts.

An aspect of the violinist hypothetical that I had forgotten was the framing of it, where I (the “protagonist” of the hypothetical) am deciding whether to extricate myself from the situation, which will result in the violinist’s death.

With that in mind, let’s return to the hypothetical I presented in my original response, and let’s also suppose one of the parents agreed to the procedure. Several months in, the child’s health is improving, but is not stable enough for the procedure to end. Isn’t the parent still free to withdraw their consent, even though that would result in the child’s death? They would be proactively choosing to take an action that results in the death of an innocent party, but don’t they still have that right? Is that a close enough parallel to the decision to get an abortion?

I do not believe that we should legally force people to help others, especially if it would put yourself in danger, outside of fairly narrow cases.

Pregnancy always puts the woman in danger. The biggest variables are the amount and nature of the danger. Do you have any thoughts on that?

As far as your boat thought experiment, I think the following tweak makes it more comparable to abortion: the kid is drilling holes of varying size through the hull, below water level. Whether or not this can or will sink the boat depends on a lot of variables, but regardless, this is not a good situation. For the sake of the analogy, let’s also say I am unable to stop the child doing this. Throwing the child overboard is not desirable for anyone involved, but if the child is Swiss cheese-ing the boat to a sufficient degree to sink it, we’ll both die. Shouldn’t I be free to decide what level of risk I am comfortable with?

Now imagine a surgical procedure by which an unborn child of any age is removed from the womb and raised to term without any dependence on the biological mother. In our boat analogy, this might be comparable to putting the drill-happy child on a lifeboat and setting them afloat. If such a procedure came to be, would you support it in lieu of abortion?

Regarding your response to the self-defense argument:

• Can we factor in financial hardship and/or long-term negative effects on mental and/or physical health as a reason to defend oneself?
• Regardless of how low the mortality rate is for childbirth overall, is it fair to dictate that women accept that risk? Why can’t we each make that call for ourselves?
• Do self-defense cases require that we prove that the defendant’s life was definitely in danger, or that the defendant knew that it was? Or isn’t it enough to prove that the defendant thought their life and/or health were in danger?

I can understand why someone who sees abortion as unethical would want to come down on that first, but we already know that outlawing or limiting abortion won’t bring down the rate at which it occurs as effectively as sex education and contraceptives. Are you also focusing on improving sex ed and access to contraceptives? Are you willing to put abortion to the side to focus on those efforts?

To be clear, I am not unsympathetic to the concerns around ending the lives of the unborn. To my knowledge, no significant percentage of the women who receive abortions are making their decision lightly. But it is their decision, and I think it should remain so.

My Response:

Thanks for your follow-up! I really appreciate your willingness to think about this deeply and really consider all the factors here; I wish more pro-choice and pro-life people would do that! 

The alternative hypothetical you presented is almost identical to the violinist, so yes, in both the violinist and in your hypothetical, I believe that you should have the right to “unplug” or remove yourself from providing support to the other person, even if that person is your own child as in your hypothetical. However, I don’t think that situation is parallel to abortion, for largely the same reasons I explained in my last response, but I will clarify a bit further here. I think that the main point you drew from my previous response was the difference between “a proactive choice to end a life, rather than a passive action that results in the life ending.” While that is something I spoke about, I don’t think that is the main difference between the two situations.

When you unplug from a sick person, you are merely “refusing to help them.” In other words, you are keeping them in their original state (in this case, their original state is dying). I don’t think that people always have an obligation to make people better off than they are naturally; maybe sometimes you do have that obligation, but that’s a lot less clear. If your child is dying and you choose to remove your support, you are returning that child to how they were originally: dying. What they ultimately die from is the disease, and you were artificially preventing that disease from continuing when you were plugged in. However, we could imagine a situation in which the parent is plugged into the child but there is no way to safely unplug from the child while the child is alive; the unplugging procedure can only happen if the child is dead. Tragically, the parent is faced with the decision to either stay plugged into the child or to ask the doctors to lethally inject the child, killing the child, so that the parent can then unplug. The hypothetical loses a lot of its rhetorical force when the parent truly only has two options: actively kill the child by lethal injection or “help” by staying plugged in. In that variation, there literally is no “just not help” option by which the parent would return the child to its original state (in this case, dying of a disease). Hypothetically, if the parent’s only options were to either donate their body to a vulnerable person or kill that vulnerable person, and there actually was no “refuse to help” option, it literally just comes down to help or kill, then I think they’re obligated to stay plugged in and help. It’s not because you are generally obligated to help. It’s because you generally may not kill innocent human beings.

There’s also another big disanalogy between the violinist/your hypothetical situation and abortion: the child, the violinist, or whoever it is that needs your body is dying. It’s always a sick person who is in need of your body in those hypotheticals. However, the fetus isn’t typically sick, and it certainly isn’t dying. Abortion is not the refusal of assistance to a sick person; it’s the killing of a healthy person. Now, a fetus is certainly underdeveloped, but I don’t think that’s the same as being sick. Infants, for example, are too underdeveloped to swim, but if you took an infant and deliberately put her in the middle of the ocean, you can’t say that’s just “refusing to help” her. You took an underdeveloped person out of an environment in which they were growing and put them in an environment where they can’t survive, so that’s still killing. I don’t want to think about what is happening in abortion procedures, but unfortunately in this case, the details matter. In the earliest stages of pregnancy the woman ingests a drug to separate the embryo from the placenta, which is how he gets his oxygen. After he suffocates she takes a second pill to cause cramping in the uterus to expel the now dead embryo. Once the embryo is too big for the woman to safely have a chemical abortion, the abortion practitioner uses suction or forceps to dismember the fetus. If the fetus is too big for a dismemberment abortion, he is first given a shot of digoxin to stop his heart and then the woman gives birth to a dead baby. Even if we can imagine a procedure without suffocation, dismemberment, or lethal injection—a procedure where the fetus is simply removed from the uterus and left on a table to die on its own—that’s still the equivalent of taking an infant out of its crib and placing it in the ocean to die on its own. I don’t think we always have an obligation to make people better off than they are naturally, but I do think we generally can’t kill people, and what happens in an abortion is indisputably direct killing.

My assertion does clearly take us to your questions about self-defense, so I’m happy to explore that concept further. I obviously agree that any pregnancy can pose some level of risk to the pregnant individual, with there being large variables for the amount and nature of the danger. Your analogy of the child “swiss cheese-ing the boat” brings up an interesting question about our individual rights to decide what level of risk we are comfortable within certain situations, and I think you’re right that it can be enough for self-defense for the defendant to prove they thought their life was in danger, as long as that belief was reasonable. However, I don’t think it’s true (or practical) to say that a person can claim self-defense for any level of risk they thought they were in. For example, let’s say that I got stuck in a small spaceship with someone who, moments after we launched into space, discovered he had an asymptomatic case of Covid-19. (Just to clarify, I’m not one of those people who is dismissive of Covid-19. It’s just the virus in this thought experiment because it’s a clearer case than a virus like Ebola.) There’s no way to turn around the spaceship, and there is zero way to isolate us from each other because the capsule is so small. Covid-19’s symptoms, side-effects, the length of those symptoms, and the odds of mortality can vary widely, and I can rightly think that my life may be in danger even though my traveling companion is completely fine! However, it seems fairly obvious that I can’t simply throw him out of the spaceship—that would be killing him. We should do absolutely everything possible to protect me from the potential dangers of Covid-19, except kill someone. 

Let me be super transparent about where I’m coming from here. I take Covid-19 very seriously. I’m fully vaccinated and have received the booster shot, and I’m frustrated by a lot of people on the political right who aren’t taking Covid-19 nearly seriously enough. I think the government has duties to protect public health, and I’m open to arguments that that could include mandates for things like masks or vaccines in certain circumstances.

However, in the US right now, you have about a 2% chance of dying if you contract Covid-19 (this statistic is understandably imprecise given the difficulty of tracking Covid-19 cases). (Editor’s note 3/17/22: The percentage is now closer to 1%, but 2% was the statistic used in the original correspondence and is unaltered here.) It’s complicated to determine what exactly constitutes a legitimate risk to your life, but it seems obvious that you can’t kill an asymptomatic person with Covid-19 even if they technically have a 2% risk to your life. I do think that people should be able to judge what kinds of risks they are willing to take, but if I killed someone with Covid-19 out of a perceived risk to my life, that seems pretty unreasonable. It seems even less reasonable when the risk is less than 1%, like the risk of dying from a pregnancy-related complication in the United States (which is 0.017%, as I mentioned in my last response). If I can kill someone who has a 0.017% chance of causing my death, I could kill just about anyone and claim self-defense!

You mentioned financial hardship as another potential reason to defend oneself. I certainly agree that financial hardship is a major problem facing pregnant and parenting people, and I don’t think that our society is doing a good enough job providing resources to assist them. We can and we must fix that, but even if we can’t—even if we somehow knew that financial hardship was absolutely inevitable for pregnant people—I don’t think financial hardship can be a sufficient justification for a self-defense killing. I can’t think of any other situation in which I can kill someone for making my life more difficult, even if it’s legitimately a lot more difficult! We need more resources and support to fix the financial hardships and other hardships of pregnancy, but I still think killing shouldn’t be an option on the table.

You also asked what I would and wouldn’t support in terms of alternatives to abortion, and I want to make sure that I address that too. If we had the technology to literally have a “just not help” option in pregnancy—a procedure by which the unborn child would be removed from the womb and raised to term in an artificial womb—I would be very willing to entertain that idea! There could be a lot of other ethical questions to explore there, but I’m definitely willing to explore those, and I hope that the artificial womb proves to be a perfect alternative to pregnancy. I’m pro-life becuase I think that killing innocent people is wrong, not because I want to control women’s bodies or stop people from having sex. So if we someday come up with a solution that isn’t killing but that also gives women an “out” from pregnancy, that would be incredible!

In terms of what else I advocate for besides making abortion illegal, we certainly have more common ground than you probably think. But before I get to that, I’m intrigued by your assertion that “we already know that outlawing or limiting abortion won’t bring down the rate at which it occurs as effectively as sex education and contraceptives” when in fact, we don’t really know that. We haven’t done any sort of scientific research on that; we haven’t tried just outlawing abortion in one area while only increasing sex education and contraceptives in a culturally and economically similar area to see what happens. There’s no data on the effect bans have on abortion rates because no one has been allowed to try in the last 50 years. But I don’t think we even need to do that to recognize that outlawing abortion will definitely bring down the rate of abortions. 

Think about it this way: the pro-choice lobby generally opposes even the smallest regulations on abortion facilities because they pose an “undue burden” on abortion. That means they worry that any restrictions could cause a woman to be unable to get an abortion. In other words, any law at all would stop at least some abortions, if pro-choice strategists are to be believed. How much more would a large-scale ban prevent abortions, if restrictions on hallway size and admitting privileges cause some facilities to shut down?

And it’s only logical that banning abortion would stop many abortions. The abortion rate doubled when Roe v. Wade legalized abortion across the country. The effects of legalization are really clear: more women wanted legal abortions than illegal abortions. It seems weird to act like banning abortion nationwide wouldn’t result in the inverse. It is likely that a lot fewer women would still choose to get abortions, for a variety of reasons, if abortion was banned.

Not to mention that we’ve been increasing sex education and contraceptives consistently for the last 50 years, and that hasn’t come close to eliminating all abortions. I don’t think it’s reasonable to think that, if we just kept increasing those forever, that would actually eliminate all the abortions. Even the pro-choice lobby itself doesn’t think so; in the recent oral arguments for the Dobbs v. Jackson Women’s Health Organization case, one of the two lawyers arguing for the pro-choice side strongly asserted “…I think the idea that contraceptives could make the need for abortion dissipate is just contrary to the factual reality.” I’ll put the whole quote below:

GENERAL PRELOGAR: Of course. So, first, this is not a new circumstance since Roe and Casey. Contraceptives existed in 1973 and in 1992, and still the Court recognized that unplanned pregnancies would persist and deeply implicate the liberty interests of women. But I think even on the facts, the state is mistaken here. Contraceptive failure rate in this country is at about 10 percent, using the most common methods. That means that women using contraceptives, approximately one in 10 will experience an unplanned pregnancy in the first year of use alone. About half the women who have unplanned pregnancies were on contraceptives in the month that that occurred. And so I think the idea that contraceptives could make the need for abortion dissipate is just contrary to the factual reality.

Just increasing contraception and sex education isn’t going to eliminate people wanting abortion. Now, I can certainly agree that banning abortion won’t stop all abortions either, but I don’t think there’s anything prohibited by law which hasn’t still been done by many people. Murder, for example, still happens despite being banned just about everywhere. But it would be really weird to argue that we should legalize murder and instead only focus on solving the social problems that give rise to a desire for people to murder because banning murder hasn’t stopped all murders! We should certainly try to solve those social problems, but murder should still be illegal too.

There are many, many organizations working to solve some of the social problems that give rise to abortion, providing more contraception, increasing sex education, etc., and I’m not trying to stop them from doing that. But on a pragmatic level, I don’t think every organization should be focused on doing everything or nothing would get done! That’s why my organization is focused on training pro-life people to have more gracious and productive conversations about abortion. If I’m right about what abortion currently is—that it’s the legal killing of thousands of people every day—then it makes sense why I would focus my time on trying to make that practice illegal. I wouldn’t be content with simply making a human rights violation less prevalent; I want it to be outlawed and less prevalent. So I certainly have no problem with other organizations who focus their efforts on a different part of preventing abortions, but my first goal is to make abortion unthinkable because the law teaches us that killing other humans is wrong.

I am not interested in controlling women, and I firmly believe that most women who receive abortions are making a very difficult decision that they in many ways may not even want. However, I think we can all agree that there are some kinds of things that the government should have laws against, like murder, rape, and assault. I’m interested in making those things happen less often, yes! But I’m also interested in keeping those things illegal because they’re wrong, and I think our government has the duty to protect innocent, vulnerable people or at the very least prevent people from killing innocent, vulnerable people. That’s why I think abortion should be illegal, too.

Please tweet this article!

• Tweet: Josh’s Abortion Dialogue with a Reader from Tangle
• Tweet: I don’t think that people should have a legal obligation to help others, but I do think we should have a legal obligation not to directly kill others
• Tweet: I am not interested in controlling women, and I firmly believe that most women who receive abortions are making a very difficult decision that they in many ways may not even want
• Tweet: However, I think we can all agree that there are some kinds of things that the government should have laws against, like murder, rape, and assault

The post Josh’s Abortion Dialogue with a Reader from Tangle 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.” 

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