The University of California is beginning a study into public demand for “missed-period pills.” The pills are just misoprostol—half of the typical chemical abortion regimen—and what they are designed to do is procure a chemical abortion without the woman needing to know whether or not she’s pregnant. In other words, it’s either a chemical abortion or an unnecessary, unindicated medical intervention, but the patient doesn’t have to know which one.

Of note: the investigation seems to presuppose the rightness of providing the pills. The only questions the researchers seem to care about are: 1) will it effectively abort human embryos; and 2) will women purchase this, especially women who might not otherwise get an abortion. In other words, they want to help women who might be uncomfortable with abortion feel better by never knowing whether or not they were actually pregnant when they took the pill. It is, after all, just a pill for your “missed period.” The lead researcher, quoted in the linked article, hopes that the pills would be a simple prescription, able to be picked up at a pharmacy, in order to assure endemic abortion access.

These pills are an ethical nightmare. “Missed-period pills” violate multiple bioethical norms, and not just because elective abortion is wrongful killing. The pills are designed to promote and cater to cowardly ethical decision-making, all the while promoting a potentially less-safe form of abortion.

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“Missed-Period Pills” Use Misoprostol Alone, Increasing Risks for Women

If the typical chemical abortion regimen utilizes both misoprostol and mifepristone, why does the “missed-period pill” only use misoprostol? It’s cheaper and readily available at most pharmacies. “Well, if that still works,” you might wonder, “why use mifepristone in the first place?” Because the use of misoprostol alone is more likely to result in an incomplete abortion, requiring surgical intervention in 22 percent of cases.

Given the high failure rate and increased risk of misoprostol alone, why would it be considered ethical to offer it as an alternative to the already-ubiquitous RU-486? What is the factor so compelling that increased risk to women is viewed as an acceptable trade off?

“Missed-Period Pills” as Schrodinger’s Abortions

The two “benefits” of “missed-period pills” are reduced “abortion stigma” and the subjective perception that the woman is not having an abortion. The first is clearly ridiculous; the people who stigmatize abortion aren’t going to be fooled if someone says she didn’t get an abortion, she just took a “missed-period pill.” It’s literally an abortion pill, designed to (inefficiently) cause an abortion.

The second is problematic in a couple ways. The use of a euphemistic name, as noted above, does not change the pill into anything other than an abortion pill, and an attempt to use such marketing to fool women or induce them to fool themselves interferes with informed consent. More troubling, though, is the idea that it’s better for the woman if she thinks, by taking the “missed period pill,” she only maybe had an abortion.

Like the famous thought experiment of Schrodinger’s cat, who is supposed to be both alive and dead because its state is indeterminate, “missed-period pills” perform what I’m calling Schrodinger’s abortion. Because it’s unknown whether the woman is pregnant or not, but we have an indicator (a missed period) that it is a real possibility, the pill treats her as both pregnant and not pregnant, so it both performs an abortion and doesn’t. The idea, then, is that women can assuage themselves that they probably didn’t have an abortion because they likely weren’t pregnant and go on with their lives.

Here’s the thing: if women aren’t pregnant, why give them misoprostol? To the extent that one believes unwanted pregnancy is an indication for an abortifacient drug (which I obviously deny), you still need the medical indication or it’s at best ethically questionable to prescribe it. A missed period, in and of itself, is not a medical indication for abortion, because abortion doesn’t do anything to a missed period, but only that which a missed period is taken to signify: pregnancy.

This pill is either performing a wrongful abortion or is a medical intervention with no justification. But better yet, the questionable, unindicated use of medical resources is being used as a placebo for the conscience, targeted at women who, because they don’t necessarily want an abortion, are most likely to fall for that marketing.

Schrodinger’s Abortion and the Modified Demolition Thought Experiment

In my article on abortion and moral culpability, I use a thought experiment in which I demolish an old warehouse building with Josh inside, either knowingly or ignorantly, as an illustration of different degrees of culpability (here, the difference between murder and manslaughter). If I demolish the building when I know that Josh is inside, I have far more culpability than if I demolish the building when I think that Josh went home sick for the day, but he actually came back to grab his forgotten keys and is inside the building. I still should have triple-checked to make sure the building was empty, so I do have some level of culpability when Josh inevitably dies. But I honestly thought he was at home, so I have less culpability than if I murdered Josh on purpose.  

We can modify that thought experiment to show why Schrodinger’s abortion is an unsatisfying moral dodge. This time, I’m demolishing the warehouse and I don’t know whether or not Josh is inside, but a co-worker comes and tells me, “Josh might be inside.” I respond, “Is he?” and am answered, “I don’t know.” If Josh is inside, I want to demolish the building and kill him in the process; if Josh isn’t inside, I don’t have any interest in killing Josh.

I know that Josh very well might be inside the building, because I’ve received a signal that there’s some indeterminate chance that a person is inside. If I demolish the building without finding out, and Josh was inside, I’m culpable for his death. If I tell the cops, “But I didn’t know he was inside,” they’d be unconvinced because I knew he might be inside and refused to check. In fact, if a person was inside the warehouse, it was my goal to kill him, so I might be more culpable than the merely ignorant person in the original thought experiment.

To explain the analogy, the missed period, like the co-worker, signals that there might be a person inside. While the normal limitations on assumed knowledge of personhood from decades of pro-choice propaganda apply, the woman has a good reason to think that she might be pregnant and the “missed-period pill” might be terminating the pregnancy—or, in more common parlance, performing an abortion. She wants the effect of the abortion if there is a person in her uterus, but (at least by the assumption of the researchers) wants not to think that she had an abortion. The possibility that Schrodinger’s abortion was no abortion at all is used as an ethical get-out-of-jail-free card.

And that doesn’t work. It doesn’t change culpability. All it does is promote moral cowardice. What I mean by that is, rather than confront the real ethical decision involved in getting an abortion, women are encouraged by this potential new “choice” to deceive themselves about the stakes of their decision. They are induced to forgo an informed decision-making process and take a pill that does they’d-like-to-know-not-what in order to make the anxiety following a missed period go away.

Even if you’re pro-choice, but you believe that any aspect of general medical ethics should apply to abortion, you should be disgusted by this. “Missed-period pills” undercut women’s informed consent and malign their status as moral agents. That said, abortion politics and the promotion of abortion at any cost have spelled the death of bioethical principles before, such as age of consent and mandatory reporting.

“Missed-period pills” should never make it to market. They are less-effective, more dangerous abortion pills by another name, except that euphemistic name also promotes moral cowardice and undermines informed consent.

Please tweet this article!

• Tweet: Like the famous thought experiment of Schrodinger’s cat, who is supposed to be both alive and dead because its state is indeterminate, “missed-period pills” perform what I’m calling Schrodinger’s abortion.
• Tweet: [R]ather than confront the real ethical decision involved in getting an abortion, women are encouraged by this potential new “choice” to deceive themselves about the stakes of their decision.
• Tweet: “Missed-period pills” undercut women’s informed consent and malign their status as moral agents.
• Tweet: “Missed-period pills” should never make it to market. They are less-effective, more dangerous abortion pills by another name, except that euphemistic name also promotes moral cowardice and undermines informed consent.

The post “Missed-Period Pills”: An Ethical Nightmare 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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