Abortion
Resources
Calkin, S. (2019). Towards a political geography of abortion. Political Geography, 69, 22-29. Retrieved from https://www.sciencedirect.com/science/article/pii/S0962629817304389
Rodger, D. (2020). Why Ectogestation Is Unlikely to Transform the Abortion Debate: a Discussion of ‘Ectogestation and the Problem of Abortion’. Philosophy & Technology, 1-7. Retrieved from https://link.springer.com/article/10.1007/s13347-020-00436-1
Räsänen, J. (2017). Ectogenesis, abortion and a right to the death of the fetus. Bioethics, 31(9), 697-702. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12404
Contents lists available at ScienceDirect
Political Geography
journal homepage: www.elsevier.com/locate/polgeo
Towards a political geography of abortion
Sydney Calkin
Geography Department, Science Site, Durham University, Durham, DH1 3LE, UK
A R T I C L E I N F O
Keywords:
Abortion
Reproduction
Feminist political geography
Scale
Pregnancy
A B S T R A C T
This article introduces a political geography of abortion, arguing that abortion access is an essential but over-
looked site where gendered mechanisms of state control are enforced and contested. Today, abortion access is
currently in the midst of a significant spatial transformation: advances in technology, medicine, and activist
tactics are currently changing the geographies of abortion and working to weaken the link between access to
abortion and national legal frameworks. In response to these challenges to state control over reproduction, states
are responding with new tactics to re-assert authority over pregnancy and abortion. However, these changes
remain under-researched in the geographical literature, which tends to sustain a focus on state-law and inter-
state travel. The forces currently transforming abortion access exceed these analytical frameworks: we require a
multi-scalar and scale-jumping account of the relationship between pro-choice activists and anti-choice states.
This article makes the case for a political geography of abortion that moves beyond a state-based framework to
account for changing patterns of resistance and restriction on abortion. The arguments are developed through
two cases: mobile abortion clinics at sea and telemedicine abortion technology, both of which demonstrate the
contestation over abortion rights at the sub- and supra-state levels.
Reproduction is a core component of nation and state-making pro-
cesses, in which the alignment between population, territory, and
community is deliberately forged. Bodies are territories onto which
states project power, but reproductive bodies crucially “make territory”
in ways that conform to and resist dominant power structures (Smith,
2012, p. 1513). State control of reproduction is inextricable from po-
litical claims about the rightful occupants of a particular piece of ter-
ritory or the categories of citizen entitled to protections by the state. To
this end, state interventions to govern reproduction are always marked
by the coupling of pro-natalist and anti-natalist policies: to perpetuate
religious and/or ethnic divisions (Mayer, 1999; Smith, 2012; Smyth,
2005); to sustain an economic system by managing the growth of the
labour force (Cao, 2015; Kligman, 1998); or to mitigate against racia-
lized demographic change (Farris, 2017; Luibheid, 2013; Repo, 2015).
Everyday intimacies – sex, pregnancy, birth, care, and family-formation
– are foundational to political communities and are therefore managed
by more or less restrictive interventions.
What role for abortion in this reproductive political geography?
Abortion regulation is a site of social control where prevailing norms
about patriarchy, heterosexuality, motherhood, and citizenship are
enforced and contested (Calkin, 2018; Fletcher, 2007; Woliver, 2010).
Abortion has always been a feature of women’s lives, although it ac-
quired its status as a fiercely contested and widely criminalized offence
within the last 150 years. The criminalization of abortion took place in
the broader context of a turn to biopolitical governance across Europe
and North America, where government action targeted the level of the
population through interventions to shape the health, survival, and
capacities of the state’s people (Miller, 2013; Petchesky, 1984; Solinger,
2005). Abortion restrictions are implicated in natalist policies of all
varieties: draconian bans on abortion have historically been employed
to grow the population of particular national groups and preserve tra-
ditional gender roles (see Kligman, 1998; Luibheid, 2013; Solinger,
2005), while coercive and violent programmes of abortion and ster-
ilization have been used to curb population growth and enforce racia-
lized projects of control (Hartmann, 2016; King, 2002; Roberts, 1999;
Wilson, 2012). Opposition to abortion has even come to direct foreign
policy objectives, determining global public health goals and driving
development spending shifts, as in the Global Gag Rule (Brickell &
Cuomo, 2018; Sanger, 2017). Abortion politics must be read alongside
broader debates about citizenship, population, and the biopolitics of
fertility in which states undertake efforts to encourage particular modes
of reproduction at home and abroad.
Abortion access today is in the midst of a significant spatial trans-
formation driven by medical and technological changes. These changes
have profound political and geographical implications because they
signal the growth of a trans-national and extra-territorial set of actors
and flows that are expanding abortion provision outside of state legal
frameworks. This paper offers a political geography account of
https://doi.org/10.1016/j.polgeo.2018.11.006
Received 9 December 2017; Received in revised form 20 July 2018; Accepted 19 November 2018
E-mail address: [email protected]
Political Geography 69 (2019) 22–29
0962-6298/ © 2018 Elsevier Ltd. All rights reserved.
T
abortion, arguing that the changing spatiality of abortion access reflects
a significant shift in the relationship between women, the state, and
reproduction. To this end, the paper brings together political geography
scholarship on scale and state power with feminist geography of re-
production to augment understandings of both. Political geography
scholarship has seriously overlooked abortion, although the issue is
central to state-led efforts to manage reproduction, population, and the
gender order. The ongoing contestation over abortion access speaks to
debates in the discipline about the de- and re-territorialization of state
power because control over abortion has come to implicate questions of
sovereignty and territorial control. Meanwhile, the extant geographical
literature on abortion cannot account for the current spatial transfor-
mation of abortion, because this literature sustains an understanding of
abortion as a matter of state law and cross-border travel. In order to
understand the changing political geography of abortion, the paper
argues, our analysis can no longer concentrate on the state as a terri-
torial container for abortion law, but it must take into account a more
fluid and multi-scalar infrastructure for abortion access outside of state-
sanctioned clinic space.
The article proceeds in four parts: first, it maps the changing spa-
tiality of abortion by tracing the traditional medical and state infra-
structures that govern abortion and the emergent patterns of abortion
mobility that work outside of these spaces. Second, it turns to the po-
litical geography literature on scale to conceptualize the modes of
multi-scalar resistance and state re-scaling that characterize this con-
testation over abortion. Third, it demonstrates that pro-choice activists
make use of mobile and digital clinic space to scale-jump and harness
scale for political claims. Fourth, it shows that anti-abortion states have
instituted a range of spatial techniques to obstruct mobile and scale-
jumping forms of pro-choice activism, especially by imposing greater
regulation on the doctor-patient interaction. It concludes by mapping
future directions in research on the political geography of abortion.
States, clinics and reproductive space
A political geography of abortion starts from the contention that
abortion is a spatial phenomenon. Its regulation has traditionally pro-
ceeded through state-imposed boundaries on when and where it could
take place, granting doctors exclusive authority over legal termination
of pregnancy. Across the diverse historical and geographical contexts in
which abortion has been criminalized and legalized, this has been en-
forced through a spatial logic of medical control. The criminalization of
abortion was politically driven by state-led projects to manage fertility
rates, but in practical terms it was made possible with the support of
anti-abortion medical associations and through the increased surveil-
lance of doctors over pregnancy. The legalization of abortion was si-
milarly facilitated with the support of the medical establishment and
through the preservation of medical authority (see Reagan, 1998;
Petchesky, 1984; Luker, 1985). Across most of the countries where
abortion is legally available today, doctors may provide legal abortion
inside formal medical spaces but states maintain criminal penalties for
abortions obtained outside of this medical context.1 This is still the case
in Britain, for example, where abortion can be legally granted with two
doctors’ approval under the 1967 Abortion Act but is otherwise crim-
inalized under the 1861 Offences Against the Person Act (Sheldon,
1997). States which permit abortion have generally done so by granting
doctors the sole authority over legal abortions and implementing cor-
responding restrictions through criminal law, medical regulations, and
a range of policy domains (Erdman, 2017). Access to legal abortion
therefore depends on authorized medical supervision inside designated
clinic spaces, while abortions outside of this context are criminalized.
States with abortion bans, by contrast, often permit women to go
abroad for abortion without prosecuting them upon their return (see for
example, Fletcher, 2013). These states attempt to symbolically enact
the status of the ‘abortion-free territory’, albeit with the expectation
that neighbouring jurisdictions will provide abortions for women who
can travel.
Abortion travel has therefore been a central feature of abortion
access past and present. In political geography terms, this means re-
cognizing that abortion access often implicates the legal contexts of
sub- and supra-state entities. Abortion travel is essential for women in
federal or devolved systems that produce a patchwork of laws within a
single political entity such as Canada, the USA, the UK, Australia, and
Mexico (Berer, 2017; Brown, 2013; Gilmartin & White, 2011; Sethna &
Doull, 2012; Whitaker & Horgan, 2016). Across international borders,
‘abortion corridors’ arise between neighbouring countries with different
legal regimes or similarly restrictive laws but different levels of en-
forcement: these corridors include Ireland-England, Germany-Poland,
USA-Mexico, and Chile-Peru, among others (see Brown, 2013; Calkin &
Freeman, 2018; Fletcher, 2016; Freeman, 2017; Side, 2016). Women
who must travel for abortion face numerous barriers, of which political
and economic obstacles often loom the largest. First, crossing borders
for an abortion requires a woman to have a passport and visa to freely
leave and enter another country. Women who are refugees, asylum
seekers, or undocumented migrants often lack this documentation and
the money required to obtain it (Gilmartin & Kennedy, 2018;
Haksgaard, 2017; Side, 2016). Second, crossing large distances for
abortion also requires a woman to have substantial financial means,
access to transport, access to childcare, and a social support network to
facilitate the trip (Pruitt, 2007, 2008; Sethna & Doull, 2012). Because
abortion travel obstacles map onto existing socio-economic inequalities
and layer up in place-specific ways, distance-based obstacles to abor-
tion are often underestimated in ways that disadvantage poor and rural
women (Pruitt & Vanegas, 2015; Statz & Pruitt, 2018). Abortion access
via travel depends on numerous inter-linking factors that extend well
beyond the laws of nearby jurisdictions: access in practice is contingent
on women’s mobility, socio-economic context, social networks and
other structural obstacles.
Despite these insights into abortion travel, the current literature on
abortion geographies is limited by its reliance on a conceptual frame-
work that centres state law and imagines abortion access as contingent
on a woman’s mobility between different abortion jurisdictions. Though
it gives consideration to the gap between the law in theory and in
practice, the extant abortion geographies literature is underpinned by
the assumption that abortion access depends on a woman’s physical
presence in an abortion clinic, thus the emphasis on barriers to abortion
travel. This focus can obscure more important trends from view because
today abortion access is becoming less connected to physical clinic
spaces and, by extension, less tethered to national legal frameworks.
The main driver of this change has been medication abortion with pills
– mifepristone and misoprostol – that provide a safe non-surgical option
for early abortions. Medication abortion pills are already widely
available in Latin American on the black market and their impact on
reproductive health has been transformative (see Oberman, 2018).
First, the safety of self-managed abortion with pills has “turned on its
head” the conventional relationship between the safety and legality of
abortion (Jelinska and Yanow, 2018, p.87). The narrative of the ‘back
alley abortion’ evokes the notion that self-managed or clandestine
abortion is, by its very nature, dangerous to a woman’s health. By
contrast, the World Health Organization has found that self-managed
abortion with pills, assisted by online medical consultation from a re-
putable provider, qualifies as a safe abortion (Ganatra quoted in
Boseley, 2017). Second, the simplicity and safety of medication abor-
tion pills means that lay activists and feminist networks can provide the
necessary information for their use where restrictive abortion laws
prevent doctors, nurses or midwives from advising patients (Coeytaux,
1 The only jurisdictions in the world where abortion has been removed from
the criminal code are Canada and five Australian states/territories: the
Australian Capital Territory, Victoria, Tasmania, Queensland and the Northern
Territory (see Berer, 2017).
S. Calkin Political Geography 69 (2019) 22–29
23
Hessini, & Allina, 2015; Gomperts, Jelinska, Davies, Gemzell-
Danielsson, & Kleiverda, 2008). Third, because a medical abortion takes
place inside a woman’s body and “is not ‘carried out’ or ‘conducted’ by
someone else”, medication abortion can give women autonomy over
the process (Berer & Hoggart, 2018, p. 1; Winikoff & Sheldon, 2012).
The public health and medical literature on medication abortion has
welcomed this transformation in clinical practice, but as yet there has
been little consideration given to its political and geographical ramifi-
cations.
Ireland provides a concise example of the broader changes in
abortion mobilities, where self-managed abortion with pills has swiftly
transformed access patterns. Under the state’s near-total abortion ban in
force until 2018, many thousands of Irish women accessed abortion by
travelling to England. At the highest point in 2001, eighteen women per
day travelled from Ireland to England for abortion; as of 2016, that
number had fallen to just under nine per day (IFPA, 2018). This de-
crease in travel has been attributed to the increase in access to illegal
abortion pills through online pro-choice networks which facilitate the
distribution of pills inside Ireland (Sheldon, 2018). One online provider
reported that, between 2010 and 2015, three to five women in Ireland
requested abortion pills every day (Aiken, Gomperts, & Trussell,
2017).2 The recognition that abortion pills were being widely accessed
in Ireland, despite the threat of a fourteen-year prison sentence for their
use, was instrumental in pushing the Irish political mainstream towards
a more permissive approach to early abortions in the lead up to its 2018
abortion referendum. Given the widespread access to abortion pills in
Ireland, laws banning their use have been and would likely continue to
be practically and politically unenforceable (Sheldon, 2016). To this
end, much of the pro-choice political discourse of mainstream Irish
politicians emphasized the danger of clandestine abortion with pills and
the need to liberalize the law so these pills could be brought back under
medical control (see for example Leahy, 2018). Abortion mobilities in
the Irish context are often associated with flows of cross-border abor-
tion-seekers and territorial narratives of ‘abortion-free Ireland’ but the
increased access to abortion pills and their impact on the political
landscape point to the limitations of a travel-centred account.
The geography of abortion access is in the process of transforma-
tion, yet the current efforts to conceptualize these changes tend to focus
on the state jurisdiction to the exclusion of other relevant spaces. A
geographical orientation to abortion shows us that contestation over
abortion is about the management and regulation of space at multiple
scales. State control over abortion has governed through the clinic
space and the doctor-patient interaction, assuming that the key ele-
ments of abortion access were co-location of patient, doctor, clinic, and
medical equipment. Consequently, the transformation that abortion
pills bring about is an alternative spatial arrangement that moves access
beyond the clinic space. This opens up a range of possibilities for pro-
choice activists to move abortion access into new spaces while it also
poses a serious challenge to the state’s ability to limit where and when
abortion takes place. Abortion’s spatial transformation requires us to
think beyond the legal frameworks of states and the mobility of abor-
tion travellers between jurisdictions, to conceptualize the mobility of
abortion pills, information, and delivery technologies in new ways. It
demonstrates the need for an alternative and multi-scalar analytical
framework that draws on political geography insights into scale and
territoriality but also works to challenge political geography to con-
ceptualize the regulation of abortion as a significant site of state-
making.
Re-scaling abortion access
A political geography of abortion takes the feminist critique of scale
as a starting point, building from this critique to note the ways in which
pro-choice feminist activism has deliberately employed and subverted
scalar categories to make political claims about state power and female
autonomy. Feminists have demonstrated that scale’s categories are in-
herently political because scholarship on scale often has the effect of re-
producing masculinist assumptions about what ‘counts’ as political, by
concentrating analysis on certain processes, places, and actors
(England, 2003; Marston, 2000; Pain, 2009). Conventional scalar ca-
tegories are premised on gender binaries and often reinforce and nat-
uralize the spatial separation of the masculine public realm and femi-
nine private sphere, although scales like the domestic and corporeal are
in fact “profoundly entwined” with the geopolitical (Dowler & Sharp,
2001; Pratt & Rosner, 2012). Moreover, because these spaces are in-
scribed with geographical, political, and legal significance, a feminist
account must strive to overcome the binary thinking that structures the
literature and account for the intimate and the geopolitical in “a single
complex” (Brickell & Cuomo, 2018, p. 2). Pro-natalist policies that re-
strict abortion serve material and symbolic functions, reflecting efforts
to shape population and national identity (see for example Kligman,
1998; Luibheid, 2013); as such, they exemplify the feminist claim that
the corporeal and geopolitical are inseparable. Emergent modes of
mobile abortion access offer a way to extend this critique: feminist ef-
forts to expand abortion access strategically embrace and politicize
scale in order to expose the limits of state interventions to control re-
production.
Geographers have widely critiqued scale, noting its tendency to re-
impose conceptual hierarchies and fit different phenomena into a set of
pre-existing scalar categories (Marston, Jones, & Woodward, 2005;
Paasi, 2004). Particular scales can easily become entrenched platforms
for analysis: this is evident in the over-reliance on state-level analysis in
the existing geographical literature on abortion. Amidst these scale
debates have been calls for the recuperation of scalar thinking as a tool
for analysis, insisting on the possibility of researching through scalar
thinking without internalizing and accepting scalar categories as nat-
ural. This entails approaching scale not just as a social construct but a
political construct: how are scales constructed and legitimized by states
or other actors? In this view, scales can be understood as political
projects that are specifically deployed by actors to “crystallize certain
socio-spatial arrangements” or to further political aims (Moore, 2008,
p. 218). Acknowledging the political uses of scale, scalar analysis can
look for its strategic deployments and effects, rather than employing
scale purely as an analytical tool that is imposed upon the data. Political
actors are generally interested in control over particular areas of ac-
tivity or policy, “rather than the command of scale per se” so they seek
to manipulate “discursive and material” aspects of scale to pursue their
agendas (MacKinnon, 2011, p. 30). This political orientation to scale is
a productive path forward in the scale debates, in part because it by-
passes the ontological question of scale’s existence and offers us a view
of scale as a political tool that is created through human action and
employed for deliberate ends.
By extension, an account of multi-scalar resistance calls attention to
the way that scales are politically constructed, employed, and trans-
formed to produce a desired set of outcomes. Neil Smith has labelled
this “jumping” or “bending” scales: it is a form of resistance in which
actors deliberately violate socio-spatial boundaries in order to make
political claims about space, power, and position. The act of jumping
between scales highlights the connection of different scales, while
“dissolving” and “abrogating” the boundaries between them (1992,
p.60). Beyond violating spatial boundaries, scale-jumping and bending
can work by redefining the power relations between different scales or
challenging the assumptions about what activities happen at particular
scales (Smith, 2004). Resistance through scale-jumping works to build
alliances between actors who are differently placed in relation to the
2 This number represents only a fraction of the actual daily demand for
abortion pills, because it reflects requests made to one of several online net-
works that provide pills in Ireland. In addition, women in Ireland source pills
through online pharmacies and informal personal networks.
S. Calkin Political Geography 69 (2019) 22–29
24
state and use their positions to leverage pressure and produce a new
policy or policy reversal. This might mean asserting the importance of
particular scales and diminishing the importance of others in relation,
forging closer connections between particular scales to achieve an
outcome, or contesting dominant power structures by multi-directional
scale jumping that challenges the presumption of ‘upward’ movement
(Cox, 1998; Swyngedouw, 2000). Scale-jumping offers activists a way
to point out the fictive and constructed nature of scales while using
material manifestations of scale to make political statements.
Forms of resistance that creatively violate spatial boundaries may
work to subvert the established structures of political power, but they
are inevitably contested. Processes of political transformation that
contest state power prompt its spatial re-arrangement, rather than its
obliteration. Scalar literature on globalization uses this dialectical re-
lationship to explain the interplay between de-territorializing forces of
capitalism that seek to compress space and time, against the re-terri-
torializing efforts of political entities that re-configure their power in a
variety of spatial forms (Brenner, 1999). Where state territorial control
is challenged or eroded, states work to reproduce the rationality of
territory across diverse scales (Elden, 2005; Shah, 2012). Multi-scalar
modes of resistance that strive to work outside of familiar political
entities are still anchored in fixed infrastructures and are always subject
to place-based interventions to govern them as such. This critique might
be understood as tempering the optimism around multi-scalar re-
sistance, by drawing attention to the way that state power is re-asserted
and re-scaled in response to scale-jumping challenges. With reference to
abortion access, pro-choice activism that jumps scale to deliberately
violate spatial boundaries and offer new platforms for digital or mobile
abortion access is interpreted as a challenge to state authority, and
states respond as such. The multi-scalar infrastructure of self-managed
abortion is continually contested and efforts to govern it are made by
states who re-scale their power to enforce abortion restrictions.
The conceptual tools of critical scale literature help to account for
the changing relationship between women, the state, and reproduction.
The transformation of abortion’s spatiality has been the deliberate re-
sult of action by pro-choice activists who have leveraged the mobility of
medication abortion pills to subvert state laws and provide wider access
through creative scalar strategies. In the different iterations of pro-
choice activism, there is an evident re-scaling of abortion that pro-
gressively reorganizes abortion to move it outside of state control first
by moving it outside of formal medical spaces. In the first instance, the
feminist networks that facilitate abortion travel have expanded access
by moving women to clinics, providing money, transport, and in-
formation to lower the barriers to access. Extending this vision of
abortion travel, pro-choice networks have employed mobile medical
clinics to invert this relationship and move the abortion clinic space to
women in states with highly restrictive laws. Yet, persistent state in-
terventions obstruct the function of mobile clinics by placing territorial
obstacles between women and clinic spaces. As such, trans-national
digital abortion networks transcend the need to facilitate co-location of
women and clinics by offering access to an online clinic space that
provides medical consultation via email or video and access to mobile
medication abortion pills through the post.
Mobile and digital clinics
The spatial re-arrangement of abortion access has come about
through calculated efforts to violate state law, expose ‘loopholes’ in the
law, and establish clandestine networks for the distribution of medi-
cation and information. The Dutch NGO Women on Waves and its sister
organization Women on Web have been central to this endeavour. Since
2001, Women on Waves has staged high-profile campaigns to provide
abortions in a mobile clinic aboard a ship in international waters. In its
ship campaigns, the organization uses the legal status of ocean space to
subvert the abortion laws that operate on land because, under inter-
national law, territorial waters only extend 12 miles off the coast
beyond which point passing ships are governed by the laws of the
country in which they are registered (Jones, 2016). Under this system, a
Dutch-flagged ship positioned 13 miles off the Polish coast is governed
by the laws of the Netherlands, not Poland; in relation to abortion law,
this means physicians can prescribe and dispense medication abortion
pills to patients on board, regardless of the patient’s nationality
(Lambert-Beatty, 2008). In its ship campaigns, the organization docks
and brings abortion-seekers onto the ship at which point it sails into
international waters and the doctor on board dispenses medication
abortion pills to the women; no surgical abortions are provided. Women
on Waves’ ship campaigns exemplify a strategic deployment of scale,
because they creatively jump scales to access the legal regime of one
state in ocean space off the coast of another. In doing so, the organi-
zation is able to move bodies across metaphorical national spaces
without travelling those distances. Women on Waves strategically
constructs a space for abortion provision that exists in a state of legal
and geographical limbo: the fictive nature of this political scale is part
of its innovation. As soon as the ship sails away, taking the mobile clinic
with it, the space will cease to exist, as will the mode of abortion access
it provided.
Ocean space exhibits a “legal pluralism” that results in complex and
overlapping modes of governance: activists can make use of this space
to subvert the laws in force on shore, although states also employ a
variety of legal strategies for extending control over vessels outside
coastal waters (Peters, 2011, 2014). Women on Waves’ ship …
O R I G I N A L A R T I C L E
Ectogenesis, abortion and a right to the death of the fetus
Joona Räsänen
Correspondence
Joona Räsänen.
Email: [email protected]
Abstract
Many people believe that the abortion debate will end when at some point in the future it will be
possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would
make possible to reconcile pro-life and pro-choice positions. That is because it is commonly
believed that there is no right to the death of the fetus if it can be detached alive and gestated in
an artificial womb. Recently Eric Mathison and Jeremy Davis defended this position, by arguing
against three common arguments for a right to the death of the fetus. I claim that their arguments
are mistaken. I argue that there is a right to the death of the fetus because gestating a fetus in an
artificial womb when genetic parents refuse it violates their rights not to become a biological parent,
their rights to genetic privacy and their property rights. The right to the death of the fetus, however,
is not a woman’s right but genetic parents’ collective right which only can be used together.
K E Y W O R D S
abortion, ectogenesis, genetic privacy, parenthood, property right, right not to become a parent
1 | INTRODUCTION
The most prominent advocates of abortion rights believe that there is a
right to terminate a pregnancy but not a right to the death of the fetus.
Peter Singer and Deane Wills phrase this in the following way: ‘Freedom to
choose what is to happen to one’s body is one thing; freedom to insist on
the death of a being that is capable of living outside one’s body is another.’1
Judith Jarvis Thomson2 believes this, and so do David Boonin3, Frances M.
Kamm4 and Mary Ann Warren.5 More recently Bertha Alvarez Manninen6
and Lindsey Porter7 have reached similar conclusions.
Whether there is a right to the death of the fetus, in addition to
the detachment, is not a question not explored in detail before. Michael
Hawking argued – using an interesting thought experiment, viable vio-
linist – that the Thomsonian defence of abortion gives the woman only
a right to detachment, not a right to end the life of the fetus once it
has reached the point of viability.8 Recently Eric Mathison and Jeremy
Davis considered in this journal whether there is a right to the death of
the fetus when ectogenesis is available.9 They concluded that there is
no such right. Therefore, the possibility of ectogenesis should end the
abortion debate to all these people.10 That is because it would then be
possible to reconcile (alleged) fetal rights with women’s rights.
1Singer, P. & Wells, D. (1984). The reproduction revolution: New ways of
making babies (p. 135). Oxford: Oxford University Press.
2Thomson, J. J. (1971). A defense of abortion. Philosophy & Public Affairs, 1,
47–66.
3Boonin, D. (2003). A defense of abortion (p. 257). Cambridge, UK:
Cambridge University Press.
4Kamm, F. M. (1992). Creation and abortion: A study in moral and legal
philosophy (p. 81). Oxford, UK: Oxford University Press.
5Warren, M. A. (1982). Postscript on infanticide, February 26, 1982. In J.
Feinberg (Ed.), The Problem of Abortion (pp. 116–119). Wadsworth, Belmont
CA; Warren, M. A. (2010). The moral difference between infanticide and
abortion: A response to Robert Card. Bioethics, 14, 352–359.
6Manninen, B. A. (2013). Yes, the baby should live: A pro-choice response
to Giubilini and Minerva. Journal of Medical Ethics, 39, 330–335.
7Porter, L. (2013). Abortion, infanticide and moral context. Journal of
Medical Ethics, 39, 350–352.
8Hawking, M. (2015). Viable violinist. Bioethics, 30, 312–316.
9Mathison, E. & Davis, J. (2017). Is there a right to the death of the foetus?
Bioethics, 31, 313–320.
10I use the term ectogenesis as it is commonly used in bioethical literature.
Ectogenesis refers the use of artificial or mechanical wombs. Ectogenesis
could be understood as an alternative to the whole gestation process where
the embryo is never inside a woman’s uterus. Here the focus is on a form
of ectogenesis which is sometimes referred to as an ectogenesis abortion
or partial ectogenesis, where the fetus removed from the woman’s uterus
alive will be gestated in an artificial womb. Although the technology is not
yet possible, the ethical issues of ectogenesis deserve careful philosophical
attention. For the sake of argument, I assume that a fetus (or technically a
blastocyst) would become a candidate for ectogenesis soon after it has
implanted in the womb.
Bioethics. 2017;31:697–702. wileyonlinelibrary.com/journal/bioe VC 2017 John Wiley & Sons Ltd | 697
Received: 6 March 2017 | Revised: 10 July 2017 | Accepted: 13 August 2017
DOI: 10.1111/bioe.12404
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I disagree. I argue that there is a right to the death of the fetus, but
that right is not a woman’s right. A right to the death of the fetus is a
right of the genetic parents and only together can they use this right. I
also consider what should be done when biological parents disagree
upon the fate of a fetus.11
Mathison and Davis considered three arguments why a woman
might have a right to the death of the fetus: 1) a right not to become a
biological parent 2) a right to one’s genetic privacy and 3) a right to
property. They argue that none of the arguments succeed. I believe
Mathison and Davis’ argumentation does not show that there is no
right to the death of the fetus. I consider their argumentation sequen-
tially and argue why there is a right to the death of the fetus. I claim –
contrary to Mathison and Davis – that because people have a right not
to become biological parents, a right to genetic privacy and a right to
their property and because ectogenesis without the consent of the
genetic parents of the fetus violates these rights, genetic parents have
a right to the death of the fetus.
I do not consider here whether the fetus itself has a moral standing
or whether it has a right to life, although I admit – and agree with
Mathison and Davis here – that to settle the issue fully, that is some-
thing which should be done.12 At the end of the article, I make some
remarks about the practical implications of my position and raise some
new questions to explore.
2 | THE RIGHT NOT TO BECOME A
BIOLOGICAL PARENT
An argument given in support of the right to the death of the fetus is
the right not to become a biological parent. Mathison and Davis (here-
after referred to as M&D) call this the ‘biological parents’ rights’ argu-
ment. Here, I frame the argument in detail and defend it against their
criticism. M&D state that spelling this argument out in more detail –
and perhaps the most common way, they say – is to argue that a right
to the death of the fetus is necessary for preventing certain harms
from befalling the biological parents. So, on this view, an abortion con-
sists of both terminating a pregnancy and preventing parenthood.
The harms in question are parental obligations which are linked to the
concept of attributional parenthood. That is the social attitude in which
others treat a genetic parent as though she still has the same moral obliga-
tions to the child as a custodial parent, even when the legal system has
absolved her of such obligations.13 Catriona Mackenzie explains this by
stating: ‘abortion is not a matter of wanting to kill this particular being,
which is, after all, as yet indistinguishable from oneself. It is rather a matter
of not wanting there to be a future child, so intimately related to oneself,
for which one either has to take responsibility or give up to another.’14
The insight of attributional parenthood leads to the Right Not to
Become a Biological Parent Argument:15
1. Becoming a biological parent causes harm to the couple because
of parental obligations towards the child.
2. The couple has the interest to avoid the harm of parental
obligations.
3. Therefore, the couple has a right to the death of the fetus to avoid
the harm of parental obligations.
M&D understand parental obligations in a way that the parents would
still feel morally responsible for the child, which then could cause them
significant psychological harm. They claim that such harm may be self-
or socially imposed. For example, others might discriminate the parents
by displaying negative attitudes or behaviour towards them. To support
this interpretation of parental obligations, M&D cite a study where sev-
eral women reported that ectogenesis would leave them with the lin-
gering sense of obligation towards the child, even if no legal obligation
were maintained.16
M&D reject the above argument. They admit that parents have a
right not to be discriminated against on the basis of attributional
parenthood, but they reject the argument by parity of reasoning. Put
another way, they claim that if the right not to become a biological par-
ent argument is sound, it leads to conclusions that are difficult to
accept (or at least which people do not currently accept). They claim
that:
[I]t does not follow from the fact that this treatment
[discrimination on the basis of attributional parenthood]
is wrong that one therefore possesses a right to the
death of the foetus. Indeed, there are reasons to doubt
that any such further right exists. To see why, consider
cases that look very similar to the one in question. Sur-
rogate mothers, egg and sperm donors, and women or
couples who give their child up for adoption may all
experience the harms of attributional parenthood, as
well as other felt obligations more generally. If the right
against the harms of attributional parenthood entail fur-
ther rights to prevent or avoid such harms in the case
we have been considering, they should entail similar
rights in these cases as well. And yet, in these other
cases, we do not typically think that the existence of
such harms gives rise to any further rights to the biolog-
ical mother or father.17
M&D seem to believe that the alleged intuitions against the claim
that gamete donors and surrogate mothers have rights towards the
child are a sufficient reason to believe that there are no such rights,
11In this article, I use the terms genetic parent and biological parent as
synonyms.
12Mathison and Davis also do not consider whether a fetus has a right to
life.
13Cohen, I. G. (2008). The right not to be a genetic parent. Southern
California Law Review, 81, 1115–1196.
14Mackenzie, C. (1992). Abortion and embodiment. Australasian Journal of
Philosophy, 70, 136–155. p. 152. Emphasis original.
15The formulation of the argument is my own, although M&D argue against
a similar argument.
16Cannold, L. (1995). Women, ectogenesis, and ethical theory. Journal of
Applied Philosophy, 12, 55–64.
17Mathison & Davis, op. cit. note 9, p. 315.
698 | bs_bs_banner R€AS€ANEN
and thus surrogate motherhood, gamete donation and adoption are
problem free practices. However, they omit the work of numerous phi-
losophers who argue, for example, that gamete donors do have parental
obligations (and perhaps rights) towards the child produced from their
gametes. Indeed, several scholars argue that no parental responsibility
theory can explain why the accidental father, who procreates due to
birth-control failure, has parental obligations towards the child but a
sperm donor does not. This notion has been brought forth by Rivka
Weinberg,18 as well as J.L Nelson,19 David Benatar,20 Melissa
Moschella,21 Reuven Brandt22 and Andrew Botterell23 – just to men-
tion a few.
It is also argued that mothers and fathers remain obliged, life-long,
to their birth children even when the child is adopted out. Lindsey Por-
ter frames this in the following way: ‘makers – that is, “birth parents”
and other causers – do not and cannot cease to be obliged to their
birth children, even when adoption takes place.’24
If these authors are correct, there is reason to believe that the
genetic parents have a right to the death of the fetus so that they could
avoid the obligations and harm of attributed parenthood. Adoption
won’t resolve the issue because parental obligations cannot fully be
transferred or delegated to someone else; such obligations are non-
transferrable in nature.
These claims might be against someone’s intuitions, but the intu-
itions alone are not a sufficient reason to believe that genetic ties, or
the fact that the parents have caused their child to exist, do not matter
in the case of gamete donation, surrogate motherhood and – ectogene-
sis abortion. Appealing to alleged intuitions is a somewhat common
way to argue in applied ethics, but without a proper theory that
explains why those intuitions are justified, the parity of reasoning argu-
ment fails. If one wants to reject the right not to become a biological
parent argument, one should offer a parental responsibility theory that
exonerates genetic parents from their parental obligations altogether
or give another reason why the argument fails. M&D do neither.
Because there are no alternative ways to avoid the harms of parental
obligations than the death of the fetus, the right to the death of the
fetus argument stands.
Some pro-choice philosophers have argued that abortion rights
include a right to the death of the fetus. Christine Overall, who has
recently changed her views about the right to the death of the fetus,
now states:
[W]omen who seek pregnancy termination are usually
choosing that there be no being at all who is their
genetic offspring. They are choosing not only not to be
social mothers, but also not to be biological mothers. In
other words, they are claiming a right not to reproduce.
(. . .) When women obtain a termination of pregnancy,
they are (. . .) acting upon their legitimate reproductive
right not to become a biological parent.25
I believe Overall is right when she claims that there is a legitimate
right not to become a biological parent. But she misses an important
point: procreation is a collective act involving two people, therefore the
biological father also has a right not to become a biological parent. The
fetus is not her project, as Overall claims, it is their project. Ergo, when
it is possible to gestate the fetus outside the womb, the fate of the
fetus is not her decision, but their decision.
3 | THE RIGHT TO GENETIC PRIVACY
Another way to argue for the right to the death of the fetus is to
claim that gestating the fetus, even if outside the womb, violates some
other rights the genetic parents possess. I believe ectogenesis abortion
violates two kinds of rights, in addition to a right of not becoming a
biological parent: a right to genetic privacy and a right to property.
There is at least in some cases a right to genetic privacy. For exam-
ple, if a mad scientist finds a way to clone humans, steals my DNA and
creates a fetus that is genetically identical to me, which he then ges-
tates in an artificial womb, my right to genetic privacy is violated.
Therefore, in such a case, I have a right to the death of the fetus.
Similarly, if ectogenesis abortions become reality, some women
(and men) will have genetic children out there who carry their genetic
material without their consent. In this scenario, their right to genetic
privacy has been violated, and the only way to avoid this is if they have
a right to the death of the fetus. Call this the Right to Genetic Privacy
Argument:26
1. People have a right to genetic privacy.
2. Ectogenesis abortion violates the genetic privacy of the genetic
parents of the fetus.
3. Therefore, genetic parents have a right to the death of the fetus.
I believe the mad scientist example shows that the first premise is true.
People in general have a right to genetic privacy. But does ectogenesis
abortion violate parents’ genetic privacy and if so, do genetic parents
18Weinberg, R. (2008). The moral complexity of sperm donation. Bioethics,
22, 166–178.
19Nelson, J.L. (1991). Parental obligations and the ethics of surrogacy: A
causal perspective. Public Affairs Quarterly, 5, 49–61.
20Benatar, D. (1999). The unbearable lightness of bringing into being.
Journal of Applied Philosophy, 16, 173–180.
21Moschella, M. (2014). Rethinking the moral permissibility of gamete
donation. Theoretical Medicine and Bioethics, 35, 421–440.
22Brandt, R. (2016). The transfer and delegation of responsibilities for
genetic offspring in gamete provision. Journal of Applied Philosophy, 33(4)
doi:10.1111/japp.12251
23Botterell, A. (2016). Why gametes are not like enriched uranium. Bioethics,
30, 741–750.
24Porter, L. (2012). Adoption is not abortion-lite. Journal of Applied Philoso-
phy, 29, 63–78.
25Overall, C. (2015). Rethinking abortion, ectogenesis, and fetal death.
Journal of Social Philosophy, 46, 126–140, p. 131. Emphasis original.
26Again, the formulation of the argument is my own, although M&D argue
against this argument.
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have a right to the death of the fetus? M&D are sceptical. They state
that even if there is a right to genetic privacy there will be considerable
limits to that right. M&D claim that at most, one has a right that her
entire genome not be released without her consent. But they don’t
argue why there is only a right that one’s entire genome not be released
– clearly more is needed than a mere declaration. M&D claim that
because the fetus’ genetic material comes only partly from the genetic
mother, the mother’s genetic privacy is not violated, in such a way that
she has a right to the death of the fetus. However, this line of reason-
ing explains only why the genetic mother has no right to the death of
the fetus. But the nature of this right has been misunderstood here.
A right to genetic privacy in the case of ectogenesis should not be
understood not as an individual but as a collective right. That is because
reproduction is not an individual but a collective action. Even though a
fetus shares 50% of its genetic material with each genetic parent
respectively, 100% of the fetus’ genetic material comes from its genetic
parents. Because having a genetic child in the world who carries the
genetic material of the parents without their consent is against their
right to genetic privacy, the genetic parents together have a right to
the death of the fetus. To use that right, however, they must be unani-
mous about it. Only if they both agree and want the death of the fetus
can they choose it to happen.
To conclude, a right to the death of the fetus is not an individual
right (as a right to terminate the pregnancy is), but a couple’s collective
right, therefore the right to genetic privacy argument stands. A right to
the death of the fetus is a right the genetic parents can only use
together.
4 | THE RIGHT TO PROPERTY
There is yet another way to claim that the genetic parents have a right
to the death of the fetus: the genetic parents own the fetus, and
because of that, their property rights are violated if the fetus is
gestated in an artificial womb without their consent. Call this the Right
to Property Argument:27
1. The fetus is property of the genetic parents.
2. People can destroy their property.
3. Therefore, genetic parents can destroy their fetus.
Common intuition seems to support both premises and therefore the
Right to Property Argument. For example, it is commonly believed that
the couple owns their (early) fetus or their embryos.28 Consider a cou-
ple who uses IVF treatment (in vitro fertilization) to get pregnant. Sur-
plus cryopreserved embryos are their embryos and no-one can use
them against the couple’s consent. In fact, it is commonly believed that
a couple using IVF has a right to destroy surplus cryopreserved
embryos. M&D share this intuition (and so do I).
Many people have inconsistent intuitions, as they believe it is
impermissible to kill the early fetus but permissible to destroy frozen
embryos. In both cases, there is an embryo involved that has a poten-
tial to develop into a fetus and then into an infant. The location of the
embryo is morally irrelevant so whichever position one holds, consis-
tency demands that the cases are treated the same, M&D claim. M&D
reject the claim that it is permissible to destroy cryopreserved embryos
and I reject the claim that it is impermissible to kill the fetus.
However, there is a way to make a moral distinction between cry-
opreserved embryos and early fetuses located inside a woman’s body.
One might claim, as Dale Jacquette does, that there are two kinds of
potentialities in question: naturally probable potentiality and merely
logically possible potentiality, and that only the former potentiality is
morally relevant.29 In the case of naturally probable potentiality, such
as what a fetus in a fully functioning womb has, the fetus’s develop-
ment into an infant is something we expect to happen, as long as there
is no fatal accident or interference involved. On the other hand, in the
case of merely logical possible potentiality, such as what cryopreserved
embryos would have, without outside interference these embryos do
not develop into anything. Although this distinction does not seem to
have implications for the ectogenesis debate, because a fetus has the
same kind of potentiality whether it is inside an artificial or a natural
womb, it does enable M&D to retain their intuitions regarding the
destruction of cryopreserved embryos while maintaining their position
about the death of the fetus. That is because a fetus located in a womb
has naturally probable potential for development, while a cryopre-
served embryo only has logically possible potential for it.
It is also commonly believed that people have a right to destroy
their property. As M&D state: ‘If we buy a rare piece of art, and sup-
posing that art can possess intrinsic value, we, as the owners, still
have the right to destroy it.’30 So why would there be no right to
destroy the fetus or the embryos? M&D argue that because even if
one owns something, there are limitations to what one can do to it.
They claim:
[C]ulturally protected buildings or artefacts can be pri-
vately owned but have use limitations. Buying a historic
building means we can occupy it, but we are not
allowed to raze it. (. . .) These limitations [to destroy] are
justified by appealing to the intrinsic value of the prop-
erty, or minimally the instrumental value the property
possess for those other than the owner.31
But why do I have a right to destroy a rare piece of art, as M&D
claim, but no right to destroy a historic building? They don’t give
any justification to why it would be permissible for the owner to27Again, the formulation of the argument is my own, although M&D argue
against similar argument.
28Although it is not a philosophical argument, it is worth mentioning that in
November 2016 a Missouri court has ruled that a divorced couple’s frozen
embryos should be treated as marital property. Retrieved from http://www.
bionews.org.uk/page_729067.asp
29Jacquette, D. (2001). Two kinds of potentiality: A critique of McGinn on
the ethics of abortion. Journal of Applied Philosophy, 18, 79–86.
30Mathison & Davis, op. cit. note 9, p. 318.
31Ibid: 318.
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destroy a rare piece of art but not a historic building – after all, they
both have intrinsic value and/or value to others. Perhaps M&D just
want to say that it is usually permissible to destroy one’s own prop-
erty but not always. So, is it permissible to destroy the fetus or the
embryos?
M&D think that because a fetus (and cryopreserved embryos)
shares only 50% of its genetic material with one individual, that individ-
ual cannot have a property right to it, and therefore has no right to
destroy it. But that is not a problem unless we want to claim that the
mother (or the father) alone has a right to the death of the fetus. That
is not the position I am arguing for. I claim that the fetus is collective
property of its genetic parents. When the genetic parents agree and
they both want the death of the fetus or the destruction of the
embryos, it is morally permissible for them to do so since they together
share 100% of the fetus’ or the embryos’ genetic material, and
gestating the fetus or the embryos against their consent violates their
rights.
Another reason why someone might reject the property right argu-
ment is that because many people are involved in the process of creat-
ing the embryos, it cannot be explained why only the parents own the
embryo. For example, M&D claim that in the process of in vitro fertil-
ization there are several people, most obviously, the doctor who
extracts the ova and performs the procedure – yet they do not have a
property right over the embryo. Therefore, we should reject this ver-
sion of the argument what M&D call the labour-mixing argument for
the property rights.
There are two responses I want to make here. First, as stated ear-
lier, many philosophers believe genetic ties are morally meaningful. If
they are right, that is a sufficient reason to believe that genetic parents
– and not the other parties – have a property right to the fetus and the
embryos. Because the doctor performing the IVF do not share genetic
material with them, he has no property right to the embryos – even
though he has taking a part of the process of creating the embryos.
Second, the objection against the labour-mixing argument for
property rights can be applied only to embryos created in the process
of IVF – not to a fetus created in normal sexual intercourse. When two
people have sex and it leads to fertilization, the two people are the
only ones bringing the fetus into existence by mixing their labour. So,
the labour-mixing argument for property rights explains why genetic
parents have property right to the fetus and why they do not have
property right to cryopreserved embryos.
Perhaps someone would object. For example, M&D argue that
because parents do not own their children, parents cannot own
their fetuses or embryos either. ‘If the justification for property is
that one has mixed one’s labour, then nothing about leaving the
womb explains why the baby is no longer the property of the
mother.’32 Obviously, children are not parents’ property. But that
has nothing to do with mixing labour. Children are not property
because children are persons: morally valuable individuals. Now,
whether a fetus is a person is a question outside the scope of this
article, although I admit that if an early fetus is a person, it might
change the outcome of the debate.33
5 | WHEN BIOLOGICAL PARENTS
DISAGREE UPON THE FATE OF THE FETUS
I have argued that biological parents have a right to the death of the
fetus. But an obvious question then rises: what should be done to the
fetus when ectogenesis is available and the biological parents disagree
regarding the fate of their fetus. There are reasons to believe that the
fetus can be killed or let die only when both parents consent to it.
First, when a man and woman are having sex, they implicitly accept
the possible consequences of their activity. As Rivka Weinberg states: ‘If
we do things that put our gametes at risk of joining with others and grow-
ing into persons, we assume the costs (and rewards) of that risky activity.’34
Because for the conception to happen, there needs to be two persons per-
forming the action (intercourse), it is those two persons that together have
responsibilities for the consequences. A right to the death of the fetus,
therefore, and for the reasons mentioned earlier, is a collective right.
Second, when only one person wants to use a collective right, he
or she cannot use that right. When Bob wants to marry Jane, but Jane
does not want to marry Bob, Bob cannot use his right to marriage,
because a right to marriage is a collective right and therefore cannot be
used alone.35 Similarly, when Bob wants the fetus to die, but Jane
wants it to live, Bob cannot use his right to the death of the fetus
because this right is not an individual but a collective right.
Third, in cases where genetic parents disagree, I believe we should fol-
low what can be called the status quo approach. According to this approach,
change needs a stronger justification than keeping things as they are.36
32Mathison & Davis, op. cit. note 9, p. 319.
33I am of course familiar with the wide scope of literature concerning the
moral status of the fetus. The most important defences of fetal rights and
the moral status of the fetus include: Marquis, D. (1989). Why abortion is
immoral. Journal of Philosophy, 86, 183–202; Lee, P. (2004). The pro-life
argument for substantial identity: A defense. Bioethics, 18, 249–263; Beck-
with, F. (2007). Defending life: A moral and legal case against …
If Abortion, then Infanticide
David B. Hershenov1 • Rose J. Hershenov2
� Springer Science+Business Media B.V. 2017
Abstract Our contention is that all of the major arguments for abortion are also
arguments for permitting infanticide. One cannot distinguish the fetus from the
infant in terms of a morally significant intrinsic property, nor are they morally
discernible in terms of standing in different relationships to others. The logic of our
position is that if such arguments justify abortion, then they also justify infanticide.
If we are right that infanticide is not justified, then such arguments will fail to justify
abortion. We respond to those philosophers who accept infanticide by putting forth
a novel account of how the mindless can be wronged which serves to distinguish
morally significant potential from morally irrelevant potential. This allows our
account to avoid the standard objection that many entities possess a potential for
personhood which we are intuitively under no obligation to further or protect.
Keywords Abortion � Infanticide � Potential � Harm � Moral status
Introduction
It is frequently claimed that there is no common ground between abortion defenders
and opponents. One side may believe that the existence of a divinely created soul
bestows value upon its possessor, or that mere membership in the human species
warrants special protection, or that fetuses are persons from conception and so forth,
& David B. Hershenov
[email protected]
Rose J. Hershenov
1
Philosophy Department, University at Buffalo, 135 Park Hall, Buffalo, NY 14260, USA
2
Niagara University, 5795 Lewiston Road, Lewiston, NY 14109, USA
123
Theor Med Bioeth
DOI 10.1007/s11017-017-9419-7
while the other side denies these. The result is deadlock. Nonetheless, there is
common ground—virtually everyone on both sides of the debate is opposed to
infanticide. However, the unwelcome news for abortion defenders is that all of the
major defenses of abortion draw upon principles that also permit infanticide. It is
well-known that defenses of abortion based upon the grounds that the fetus is not a
(neo-Lockean) self-conscious person would allow infanticide as well. But though
less well known, infanticide would also be allowed by abortion defenses that rely on
Judith Thomson’s [1] appeal to a woman’s control of her body, Elizabeth Harman’s
[2] and David Boonin’s [3] reliance on the moral significance of consciousness,
Agnieszka Jaworska and Julia Tannenbaum’s [4] stress on the absence of a rearing
relationship, Elselijn Kingma’s [5] claim that the fetus is literally a part of the
mother, or the American Supreme Court’s resort to viability.
We contend that there is no way to distinguish an infant from a fetus in terms of
an intrinsic morally relevant feature that the former has and the latter lacks—neither
one is rational, morally responsible, self-conscious, concerned about the future, etc.
They both lack the cognitive abilities of most household pets. There have been
attempts to distinguish healthy fetuses from newborns, but they are no more
successful in securing considerable moral status for infants than pointing out that
rabbits and dogs differ in their mental abilities can bestow any significant moral
status upon the more mentally advanced dog. For instance, Jose Bermudez [6]
appeals to a minimal sense of self that newborns acquire through imitation. But the
sense of self in the newborn is far less than that possessed by the dog that misses its
departed owner and anxiously awaits his return, so it is surely too rudimentary to
matter morally. Likewise for Regina Rini’s point that when a fetus becomes
biologically independent of its mother, it has aims that it did not before as it
responds to needs for warmth and food and other needs by ‘‘playing the tiniest role
in their accomplishment through its grasping, suckling and crying…. [N]ewborn
infants have aims, but fetuses do not … if the vulnerability of such aims to
frustration is morally significant, then there is a morally relevant difference between
a fetus and a newborn’’ [7, p. 356].
1
Not only are these aims limited to healthy
infants, not to premature or ill infants, but they do not distinguish the infants’ moral
status from that of any household pet or backyard animal. Other philosophers like
Mary Anne Warren write of the bombardment of stimuli that distinguishes birth
from prenatal existence and that the birth of the infant ‘‘marks the beginning of the
infant’s existence as a socially responsive member of a human community’’ [8,
p. 62]. Not only is this not true for premature or ill newborns, but even if it did
distinguish the infant from the fetus, it could not justify any moral status of any
significance since countless non-human young have equivalent abilities but are
accorded little moral status in virtue of them.
That the newborn has not reached a stage of development that bestows intrinsic
value and warrants protection can be more clearly seen if one eliminates any subtle
influence of the potentiality of the infant on one’s thought by imagining another
1
Warren, in her paper on the moral significance of birth, provides counterexamples to Rini’s claims that
‘‘Newborn infants have aims but fetuses do not.’’ Warren points out that late term fetuses, like infants,
turn away from bright lights, respond to loud noises, voices, or others sounds, and are also responsive to
touch, taste, and motion [8, pp. 49–50].
D. B. Hershenov, R. J. Hershenov
123
species that normally develops mental states comparable to that of the human infant
but then naturally stagnates, i.e., stays alive but undergoes no further cognitive
development. Such creatures would have very little moral status and we would seem
to be obliged to do little, if anything, to save them, and would not have to take on
much more in the way of burdens to avoid killing them.
2
In addition to rejecting intrinsic bases for distinguishing infants and fetuses, we
will also show that it is unsatisfactory to attempt a distinction on an extrinsic basis,
for it is not always the case that infants can survive independently of their mother’s
bodily support, are less of a burden on their mothers than fetuses, or are in a morally
significant relationship that the fetus is not.
The logic of our position is that if the standard arguments for abortion justify the
practice, then they also justify infanticide. In this article, we will consider the
following five well-known arguments for abortion and show not only that they
justify infanticide but also that the principles they rely upon are not morally
compelling.
3
(1) The inequity of imposing burdens only upon women, but not men,
justifies a right to abort. (2) The fetus does not warrant protection until viable. (3)
The bodily burdens of pregnancy are too great to deny women an autonomy right to
abort throughout their entire pregnancy. (4) Non-sentient fetuses can be aborted
because they lack moral status prior to the onset of consciousness. (5) Fetuses are
parts of the mother, newborns are not. Following this critique, we will then help
ourselves to modus tollens and argue that since infanticide is widely rejected,
abortion should be as well.
Alas, we cannot today just assume that our readers will accept that infanticide is
beyond the pale.
4
Some readers will admit that we have shown that abortion and
infanticide are morally the same, but opt to permit both rather than prohibit both. So,
we will further argue that when potential is properly understood, abortion and
infanticide can be seen to be a considerable harm and evil. We contend that both the
defenders and critics of potentiality arguments in the abortion debate have failed to
appreciate that the potential of mindless or minimally minded creatures that matters
morally is their potential for healthy development. We argue that crucial for
understanding the moral significance of potentiality is the fact that mindless
organisms have interests but only in their healthy development. When they are
mindless, they are without interests in other potential futures. Unlike most kinds of
organisms that develop minds, the operations of a healthy human mind are of a
sophistication and range that bestows them with great value and enables their
possessors to obtain unrivaled levels of well-being. Thus, the frustration of those
interests in healthy mental development is a great harm. Since the healthy
development that is in the fetus’s interest can require all sorts of extrinsic
2
We assume killing is morally worse than letting die, and the evidence for that belief is that one must
take on more burdens to avoid killing someone than to allow an individual to die. For support, see Frances
Myrna Kamm [9].
3
We are not aware of any other principled defenses of abortion that do not also generalize to allow
infanticide. For example, just stipulating that birth bestows the moral status required for protection
against being killed does not provide a principled distinction between abortion and infanticide.
4
Alberto Giubilini and Francesca Minerva recently defended ‘‘after-birth abortion’’ [10]. Michael Too-
ley [11], Peter Singer [12], Jeff McMahan [13], and John Harris [14] earlier argued for infanticide.
If Abortion, then Infanticide
123
interventions, the morally relevant potential is not limited to that which is intrinsic,
active, normal, or probable. And given that those real or hypothesized non-human
beings who are supposed to show the absurdity of protecting potential are not
unhealthy if the mere possibility of their personhood is not actualized, then it
follows that they do not have any interests frustrated by that potential going
untapped. So, potentiality properly construed in terms of healthy development is not
susceptible to reductio ad absurdum, unlike understandings of potentiality as
metaphysical or physical possibility.
Ours is not the only theory to maintain that moral status does not depend upon
sophisticated mental faculties that have already been manifested. So, we finish with
a discussion revealing that our appeal to non-intrinsic developmental features is
successful where an appeal to person-rearing relationships of Jaworska and
Tannenbaum [4] is not. We also show that the latter, like all the other discussed
cutoff points alleged to permit early abortion but not the killing of more developed
human beings, would have to tolerate infanticide.
An abortion ban violates a woman’s right to equal treatment
Since only women get pregnant, they suffer unequally because of their biology. Men
are free from the physical burdens and dangers of pregnancy, as well as the loss of
employment, educational and social opportunities due to unwanted pregnancies, and
child raising. If women are not allowed to choose to be free from a pregnancy that
men naturally avoid, they will bear unequal burdens and be permanently relegated
to second class citizenship.
5
Therefore, some conclude that women are entitled to
abort unwanted pregnancies.
We suspect that few abortion defenders will, upon reflection, insist that abortion
is unjust because it involves an unequal distribution of burdens that falls only on
women. While it is true that only women can get pregnant and no comparable
burden is imposed upon men,
6
we suspect that equality is really beside the point.
This suspicion is partially based upon our belief that if men could also get pregnant
and consequently experienced equal limitations, those using this argument to defend
abortion would still endorse a right to abortion. Egalitarian abortion defenders
would not want abortion rights to go away if motherhood increases a woman’s
standing above that of men. Imagine that more respect and power came with more
children [16, p. 98]. Nor would they want abortion rights to vanish if men were
5
Variations of the equality defense can be found in Catherine McKinnon [15], Martha Nussbaum [16,
pp. 342–343], Melinda Roberts [17, pp. 162–164], Alison Jaggar [18, pp. 147–149], Cass Sunstein [19,
pp. 29–44], and Sally Markowtiz [20, pp. 12]. Even Thomson [21] expresses some sympathy for this
position, though she is better known for appealing to a bodily control defense [1].
6
Perhaps wars were once fought in such a physically demanding manner that the armies had to be
drafted from only the ranks of men. More likely, the nature of battle only required wars to be fought by
the conscription of men or women of sufficient strength. Perhaps then the physically strong were
disadvantaged by their biology but not wronged. However, the benefits and burdens of fighting may be
too disanalogous to child bearing to be used in an analogical argument.
D. B. Hershenov, R. J. Hershenov
123
legally required to take on more childcare burdens after birth so that the mothers did
not lose out on social-economic opportunities.
This inequality argument provides a defense of infanticide. If we modify a
Frances Myrna Kamm example, imagine that women so bond with their children
around a week after childbirth that they cannot give them up for adoption or let
anyone else provide for their day care. Our society surely would not let them
commit infanticide in the week before the unbreakable bonds set in. If such changed
desires are too farfetched, then imagine a woman giving birth in an isolated
community where there is not any digestible formula, breast pumps to fill up bottles,
available wet nurses, or other substitutes for her nursing. Thus, the mother must
breastfeed around the clock. Assume this is painful as well as exhausting, and limits
her social, educational, and professional opportunities more than it limits the
father’s opportunities. Nevertheless, the mother surely cannot kill or let die the
nursing child despite these considerable burdens being unequally distributed.
7
Whatever one thinks about the need for more equality, it is typically maintained
that one cannot kill to remove barriers to equality, especially when those killed are
not blameworthy. So, if inequality arguments do not justify infanticide, then why
would they justify abortion? We have already mentioned that there is not any
intrinsic morally significant difference between fetuses and newborns. The isolation
in the second infanticide thought experiment removes the typical extrinsic
difference between fetuses and infants: the burden of the infant being transferable
to others. The limits of the equality approach support our suspicion that avoiding
inequities is providing a reason to have an abortion that ultimately must be justified
independently from social inequalities.
8
So, if the inequality presently plays any role
here, it is just intensifying the existing grievance of having one’s bodily freedom
restricted in a society where women have historically been denied the opportunities
of men. We think that what is far more likely to be doing the real moral work in this
defense of abortion is a belief that a woman’s autonomy allows her to refuse to take
on the immense physical burdens involved in pregnancy, regardless of whether the
burdens are universally shared. Unequal treatment is really beside the point, for such
an exercise of autonomy would be deemed legitimate for men as well if they could
become pregnant or faced equal burdens and opportunities.
9
7
Any concerns that such unequal burdens are not considerable enough—thus, that infanticide is unjust
while abortion is not because nursing is not as difficult as carrying a fetus to term—will be met by our
response below to the fourth argument.
8
Our view is shared by Kamm [22, p. 98].
9
We should qualify our claim and recognize the case of Sally Markowitz, brought to our attention by an
anonymous referee, who would seem to accept the inequality defense of abortion even if that means
abortion could be banned in a truly egalitarian society. The conclusion of Markowitz’s 1990 article is,
‘‘Let feminists insist that the condition for refraining from having abortions is a sexually egalitarian
solution’’ [20, p. 12]. So, that remark and earlier comments that are somewhat dismissive of the autonomy
defense of abortion may indeed mean that Markowitz would prefer the equality justification to the
autonomy defense of abortion. Markowitz writes, ‘‘Autonomy arguments though are not much of an
improvement. They take into account the well-being of individual women but they manage to skirt the
issue of woman’s status, as a group, in a sexist society’’ [20, p. 3]. Nevertheless, we still suspect that most
of those who appeal to the equality defense will fall back on the autonomy defense given that it could
mean abortion rights would lose that justification in an egalitarian society.
If Abortion, then Infanticide
123
Abortion is permissible until the fetus becomes viable
We will first consider viability to mean that the fetal individual can live
independently of the gestational mother and then subsequently understand it to
mean that an individual can live independently of any particular person’s bodily
support or mechanical substitute for an immature or failing biology. On either
construal, if the principle of viability truly forms the basis of the abortion
defender’s position, then it will allow for infanticide. Consider a woman giving
birth in an isolated community where adoption services are absent or she is unable
to put the child up for adoption for months. Assume, as before, that there is no
alternative to around-the-clock breastfeeding because there is no formula available
or the baby cannot digest it. The infant is not viable because she cannot live
without being sustained by internal products of the mother’s body. If the reader
insists that the newborn who needs her mother to produce milk is just generically
dependent upon the mother’s body, unlike the gestating embryo whose needs
cannot be met by anyone else, then we can just stipulate that the mother’s milk is
unique and no wet nurse can be substituted. Surely the mother cannot legitimately
bring about the death of her dependent newborn even though the child is not
viable, i.e., cannot live without the support of the nourishment provided by her
body.
10
So, independence from one’s mother cannot be the basis of the moral
status that protects one’s life.
We can also easily show that viability is not a morally significant principle if the
term just means that one can live independently of the biological support of others,
not just the mother. Consider conjoined twins. There is not a lack of moral status if
one or both are unable to survive separation surgery and live independently of the
other. Or imagine someone’s failing body resulting in their needing medical
equipment to stay alive. Such people would not lose any moral status during the
time they lack viability.
We suspect that most of those who defend abortion by appeal to viability do not
really believe viability is morally significant. Their lack of a deep commitment to
the principle of viability can be revealed when they are asked to imagine
hypothetical scenarios where the timing of the onset of viability is changed.
Consider first a scenario in which viability does not occur until late in the ninth
month of pregnancy, though all other development continues normally. Abortion
would be permitted virtually up to birth. But few abortion proponents would be
comfortable with this, even though they should not be disconcerted if viability truly
mattered morally. Next, assume that the onset of viability occurs just a few days
after conception. Most women would discover they are pregnant after the embryo
becomes viable and thus virtually no abortions would be justified.
11
But if viability
is held to be a morally legitimate cut off point for abortion, then whenever it occurs,
10
If one objects that the mother would just be letting the child die by not feeding it, then imagine a
hungry infant aided by a relentless adult who continually places the newborn upon the woman’s breast.
The only way to stop such imposed feedings is to kill the infant.
11
To meet the objection that such women could still avoid the pregnancy by giving birth prematurely, we
stipulate that some pregnant women are too frail to safely induce labor, though they could safely abort.
D. B. Hershenov, R. J. Hershenov
123
that threshold should be morally acceptable.
12
But the discomfort with viability as a
cut-off point, if it were to occur much sooner or much later, suggests to us that what
really accounts for the appeal of viability is not the actual principle of total
independence from the mother but just the current time at which our existing
biotechnology enables the fetus to become capable of living outside the womb. We
surmise that the attraction of the current onset of viability at roughly six months
after conception is because it gives women a grace period to reflect upon such a
weighty decision and still allows abortion defenders to admit the nearly-born fetus
has some value and deserves a modicum of respect and protection without forcing a
woman to provide an unwanted nine months of bodily support.
Consciousness distinguishes abortion from infanticide
Some philosophers defend the position that consciousness is a morally significant
threshold that can distinguish earlier permissible abortions from later impermissible
abortions. Our response is that they are overestimating the importance of their own
thoughts—and everyone else’s. They need to explain why consciousness is
important for immunity from being killed.
13
Is it because the conscious person
would then undergo a painful death? It would seem not. An infant (or anyone) could
be painlessly killed while asleep, but surely that is wrong. Is it that consciousness
brings a morally significant cutoff point for permissible abortions because only the
conscious can have certain interests that warrant protection? Again, the answer
seems to be no. Consider a newborn unaware that she needs some high tech life-
saving procedure to avoid a painless disease and death. Surely, it is in the infant’s
interest to have her health maintained even though she is not conscious of that
interest.
The existence of interests that one is unaware of is what makes it so hard to
believe Harman’s claim that while mindless embryos have an interest in continued
life and are greatly harmed by their death, such interests do not have moral
significance since the embryos are not conscious [2, p. 185]. It is very difficult to see
why consciousness would make such harm a morally significant harm if the
conscious newborn is not conscious of its longstanding interest in its life being
preserved. So, if consciously conceptualizing that interest is not required for that
interest to belong to the infant and to matter morally, why would that interest not
exist earlier and be morally significant in the embryo before there is any
consciousness at all? Alternatively, if the mindless embryo is not protected from
abortion because it does not have an interest in more life in the absence of a
conscious concern with living on into the future, then it is difficult to see why the
12
Contrast viability with the onset of an obviously morally significant trait like having a mind like ours.
If a mutation resulted in such a mental life arising in the fetus before viability, many who previously
accepted abortion at that stage would find it nearly impossible to do so anymore. At best, they would have
to rely upon Thomson-like arguments that refer to features extrinsic to the fetus, such as it being an unjust
burden upon the unwilling mother.
13
Harman surprisingly declares that she ‘‘will not offer any independent argument for’’ the claim that ‘‘a
being has moral status at t just in case it is ever conscious and it is not dead at t’’ [2, p. 184].
If Abortion, then Infanticide
123
fact that the infant is already conscious protects it against infanticide, if it has not
consciously entertained a concern with surviving into the future.
Boonin claims that the newborn should be accorded an idealized desire in staying
alive [3]. He argues that the newborn’s desires for warmth and food etc. gives her an
idealized desire to live so as to fulfill those conscious desires. He compares the
newborn’s desire for more life to the idealized desire of a hiker to go left at a fork
because he is unaware of a bomb planted on the path forking to the right. The hiker
has desires in avoiding injury, pain, etc. that would give her an idealized desire to
avoid the bomb on the right fork even though she is unaware of its presence. We
argue that Boonin’s account is insufficient because the newborn has interests that
cannot be explained by idealization. The newborn can have a non-conceptualized
interest in surgery that will ensure reproductive capacities or a certain kind of
intellectual growth that does not serve any of her present desires in warmth, food,
etc. We even hypothesize that the newborn can outgrow its existing desires but still
retain an interest in future life that it does not conceptualize. For example, the
interest in food is really just a desire to remove a feeling of discomfort, at least
before the first breastfeeding. We take perhaps some liberties, but harmless ones, to
make our point by imagining that the baby’s qualia and desire for the first liquid
meal is unlike the qualia and desire later for solids. The newborn surely has an
interest in living and a right to life that she cannot conceptualize which is not
captured by an idealization ensuring existing desires are satisfied. If not, infanticide
is acceptable. So if an infant has interests that she is unaware of that are not
idealizations from given existent desires, the same is true for the non-conscious
fetus.
It cannot be that the onset of consciousness by itself so increases a creature’s
value that it becomes wrong to kill it. There are countless types of nonhuman
animals that are conscious but have very little moral status. So consciousness per se
seems to bestow little value. It is really the potential for a certain type of
consciousness that matters morally. But Harman, perhaps influenced by Shelly Ka-
gan’s [23] discussion of the additive fallacy, is sympathetic to the idea that it is
consciousness and potentiality that together bestow moral significance. Kagan
diagnosed an additive fallacy where the reduction of value due to the removal of one
feature wrongly led to a belief that the value of the whole was to be determined by
adding the value of the components. An analogous mistake would be removing an
ingredient from a recipe that resulted in it tasting half as good as it did before and
thus thinking that the removed ingredient provided half of the good taste. If the meal
scored a six on a taste scale, the removed ingredient would then be ranked a three
according to the fallacious additive inference. But that ingredient may have been
rather bland by itself, so its contribution with other ingredients to the fine taste of the
meal is better captured by a multiplier than an additive effect.
However, we can show the unimportance of multiplying consciousness with
potentiality if we imagine a scarce life-saving drug that one can either give to a five-
month-old fetus that just became minimally conscious a day earlier or to a fetus that
will become minimally conscious in a day. Consciousness, in this case, seems to
hold little value; it appears to be a coin toss to decide who gets the drug. Such
reactions suggest that we are not guilty of an additive fallacy and overlooking how
D. B. Hershenov, R. J. Hershenov
123
potentiality and its partner properties produce value via multiplication. Such
responses to the scarce drug choice scenario perfectly cohere with our claim that it
is the potential for personhood of the embryo at any stage that matters rather than
the potential for personhood only of the conscious.
A perennial challenge for the abortion proponent is to defend abortion without
offering a justification of infanticide as well. Some abortion defenders argue that
consciousness is what provides moral status and what makes late abortion and
infanticide wrong, but not early abortion. It is standardly thought that consciousness
emerges around five months after conception. So, one feature that appeals to many
is that early fetuses can be killed but that consciousness protects the infant.
However, unhealthy newborns might lack consciousness such that infanticide is not
ruled out in their case. Perhaps some people will accept the killing of the mindless.
Even so, we doubt they would if the lack of infant consciousness was temporary.
But then it is hard to see why the temporary unconsciousness of the fetus fails to
protect it.
We suspect that most abortion defenders are, unbeknownst to themselves, not
really committed to the moral …
COMMENTARY Open Access
Why Ectogestation Is Unlikely to Transform
the Abortion Debate: a Discussion of ‘Ectogestation
and the Problem of Abortion’
Daniel Rodger1
Received: 9 October 2020 /Accepted: 22 October 2020/
# The Author(s) 2020
Abstract
In this commentary, I will consider the implications of the argument made by
Christopher Stratman (2020) in ‘Ectogestation and the Problem of Abortion’.
Clearly, the possibility of ectogestation will have some effect on the ethical debate
on abortion. However, I have become increasingly sceptical that the possibility of
ectogestation will transform the problem of abortion. Here, I outline some of my
reasons to justify this scepticism. First, I argue that virtually everything we already
know about unintended pregnancies, abortion and adoption does not prima facie
support the assumption that a large shift to ectogestation would occur. Moreover,
if ectogestation does not lead to significant restrictions to abortion, then there will
be no radical transformation of the practice of abortion. Second, abortion is
already associated with stigma, and so the presence of ectogestation would need
to create additional stigma to modify behaviour. Finally, I argue that ectogestation
shifts the debate away from the foetus to the human subject of the artificial
womb—the gestateling, therefore creating a new category of killing—gestaticide.
However, this would only reorient the debate rather than end it.
Keywords Abortion . Pregnancy . Infanticide . Gestation . Ectogestation . Adoption
1 Introduction
Christopher Stratman (2020) defends the claim that there is no right to the death of the
foetus when ectogestation is possible, even if they lack the moral status of a person.
Philosophy & Technology
https://doi.org/10.1007/s13347-020-00436-1
* Daniel Rodger
[email protected]
1 School of Health and Social Care, London South Bank University, 103 Borough Rd., London SE1
0AA, UK
This is a conclusion I have argued for previously (Blackshaw and Rodger 2019) in
response to those who have argued to the contrary (Räsänen 2017).1 Though there are
many arguments against the claim that there is a right to the death of the foetus, it seems
unlikely that the possibility of ectogestation will radically transform the abortion
debate—especially that it will cause a reduction in the incidence of abortion.
Here, I briefly outline some challenges against Stratman’s (2020) claim that the
possibility of ectogestation—a period of gestation in an artificial ex utero
environment—will radically transform the problem of abortion. First, I argue that virtually
everything we already know about unintended pregnancies, abortion and adoption seems
to suggest that a large shift to ectogestation is unlikely to occur. Moreover, if ectogestation
does not lead to significant legal restrictions on abortion, then there is unlikely to be any
radical transformation on the practice of abortion. Second, abortion is already associated
with stigma, and so the presence of ectogestation would need to increase the existing
stigma to modify behaviour away from abortion. Finally, I argue that artificial womb
technology shifts the debate away from the foetus to the human subject of the artificial
womb—what Elizabeth Chloe Romanis (2018) has termed the gestateling. It creates a new
category of killing—gestaticide—which will more closely resemble the ethical debate
around infanticide rather than abortion (Rodger et al. 2020).
2 Adoption, Harm and Stigma
Women who have an unintended pregnancy can already entrust the moral and legal
responsibilities of parenthood to a competent individual or couple—via adoption. In
many ways, ectogestation allows for the same opportunities as adoption. In both cases,
the resulting gestatelings’ or neonates’ needs are met by something or someone else.
Moreover, both provide a means for continued human existence, in contrast with
induced abortion. One obvious difference is that in the case of ectogestation, the period
of gestation would be less than completing a normal pregnancy (e.g. perhaps they could
be transferred to an artificial womb at 24 weeks); otherwise, there would be little reason
to opt for ectogestation over adoption in the case of an unintended pregnancy.
Women with an unintended pregnancy are the group most likely to have an abortion,
with 61% of unintended pregnancies between 2015 and 2019 ending in abortion
(Bearak et al. 2020); globally, 25% of pregnancies end in abortion (Sedgh et al.
2016). Therefore, ectogestation would need to be employed very early on in the
pregnancy—because women who would otherwise seek an abortion will likely not
want to be delayed in relieving the burdens they perceive or associate with their
pregnancy. In most high-income countries, at least 90% of induced abortions are
completed before the 13th week of pregnancy (Popinchalk and Sedgh 2019). Most
women who consider abortion do not choose to complete the pregnancy and give their
child up for adoption (Sisson et al. 2017). Unless it is medically indicated, women do
not and are not legally permitted to request to deliver their foetus prematurely at the
point of viability (24–28 weeks) with the intent that the child receive neonatal intensive
care under the responsibility of adoptive parents. If ectogestation is to function as an
alternative to abortion, this is what women would be expected to do. However, based
1 As have many others, see Mathison and Davis (2017), Hendricks (2018), and Kaczor (2018).
D. Rodger
on what is already known about women who consider and procure abortions,
ectogestation would need to be available at a much earlier stage of pregnancy than
the point of viability.2
The reasons for not opting for foetal transfer surgery, ectogestation and adoption are
likely to be similar or the same as those given for not completing the pregnancy and
giving the child up for adoption. In fact, there are additional reasons for women to
object to this process—the need for invasive surgery to transfer the foetus into an
artificial womb despite the fact that abortion obtained early in pregnancy is relatively
safe for women (National Institute for Health and Care Excellence 2019).
The invasive surgery required for a foetal transfer is likely to be analogous to the
surgery required for a caesarean section, and therefore, the risks involved will be
closely aligned. Given that the vast majority of induced abortions occur before the
13th week of pregnancy, the overall risks (e.g. rates of serious complications) are likely
to be lower—where abortion is legal—than those that would be associated with foetal
transfer surgery, if they reflect the risks associated with caesarean section.3 This in itself
is not an argument for abortion; otherwise, the increased complication risks associated
with naturally giving birth compared with early abortion could be used to argue that
abortion would be clinically indicated for all pregnancies.4 This point merely shows
that the increased risks that would be associated with foetal transfer surgery, when
compared with the comparatively lower risks of early induced abortion, are likely to
reinforce the decision to opt for abortion and not ectogestation.
In a study of women in the USA who had abortions, the reason they gave for not
giving their child up for adoption was that giving up one’s child was considered
morally unconscionable (Finer et al. 2005). This is congruent with the existing research
that explores women’s views of ectogestation compared with abortion (Cannold 1995;
Simonstein and Mashiach-Eizenberg 2009). In a qualitative study by Leslie Cannold
(1995, p.60), adoption (and ectogestation) was understood by some women as an
‘irresponsible abdication…of their maternal responsibilities’. Furthermore, the use of
ectogestation for resolving an unintended pregnancy was viewed negatively by women
irrespective of their views on abortion, even when ectogestation was described as no
more medically risky or inconvenient than abortion (Cannold 1995). This means that
even if there is no right to the death of the foetus, the possibility of ectogestation is
unlikely to affect women’s decision-making if adoption is perceived as being psycho-
logically distressing (Jones et al. 2008).
The primary reason that we would expect women to opt for ectogestation would be if
legal restrictions were implemented against abortion based on the presence of artificial
womb technologies. This is of course theoretically possible but improbable—especially
in countries where legal abortion is not connected to foetal viability. It would require a
significant shift in the current cultural and international trajectory of abortion legislation.
This trajectory is evidenced by the trend towards decriminalising abortion, most recently
in Northern Ireland in 2019 (Aiken and Bloomer 2019), and expanding the legally
permitted grounds for abortion (Guillaume and Rossier 2018). In other words,
2 Realistically, ectogestation would need to be available prior to 13 weeks to act as an alternative to abortion.
3 For a discussion of a similar point and an argument for why ectogestation should not be considered as an
alternative to pregnancy or abortion, see Romanis et al. (2020).
4 For a discussion of this point, see Blackshaw and Rodger (2020).
Why Ectogestation Is Unlikely to Transform the Abortion Debate: a…
international trends appear to be moving towards broadening abortion access, not
restricting it in ways that would be required were ectogestation to become available.
A central question, therefore, is this: if—many or most—women who are consider-
ing abortion tend to pursue abortion rather than adoption today, what reason do we
have to think this will change when ectogestation becomes a reality?
First, given the additional risks that are posed—however small—there does not seem
to be any obvious reason why women who would consider abortion would opt for
ectogestation when they so rarely choose to complete gestation (or at least wait until
viability) and then give their child up for adoption. In fact, not only are there risks
posed by surgery, but presumably there would also be some risk to the foetus from the
transfer to the artificial womb, risks that are likely to outweigh those it would be
exposed to if the pregnancy was left uninterrupted. Ectogestation, if completed around
the time that most abortions are completed, would entail that women with an unin-
tended pregnancy are spared the responsibilities and challenges of an extended period
of pregnancy, but if one intends to give one’s child up for adoption—for the child’s
long-term benefit—then why not opt for completing the pregnancy without all of the
additional risks? The artificial womb technology being developed is aimed primarily at
reducing neonatal mortality caused by premature birth (Partridge et al. 2017) and would
likely be utilised by women experiencing a pregnancy that poses a risk to their own
health (Romanis et al. 2020). It is not being developed as an alternative to abortion as
the technology is not expected to be within the purview of early pregnancy. If
ectogestation entails a risk to the mothers’ health and an additional risk to the
gestatelings’ health and adoption is viewed by women considering abortion as psy-
chologically harmful and morally irresponsible, then ectogestation is unlikely to radi-
cally transform the problem of abortion.
Second, one must consider the potential social changes that the possibility of
ectogestation could bring about. Artificial gestation compared with natural gestation
would be visible—gestation becomes observable in a way that was only possible
infrequently under ultrasound. This is not beyond the realms of possibility as the
Biobag used to gestate lamb foetuses for up to 28 days by Partridge et al. (2017) was
transparent and therefore observable throughout the process. Artificial gestation could
become something of a spectacle that can be enjoyed by the parent/s, family, friends
and the community. It may also have the effect of humanising the subject of
ectogestation—the gestateling—and creating increased stigmatisation of induced abor-
tion. It is possible that ectogestation will cause an increase in stigma that could
discourage some women from obtaining an abortion. However, given the risks in-
volved with ectogestation outlined above, an increase in stigma towards abortion may
lead to an uptake in adoption without the use of ectogestation. Moreover, stigma
against abortion already exists (Cárdenas et al. 2018; Biggs et al. 2020), and adoption
is already an option. Ectogestation, therefore, would have to create additional stigma to
have any real effect on the incidence of induced abortion.
3 Problems That Must Be Overcome
The problems I have outlined are not insurmountable. It could be the case that
ectogestation can one day start safely from the first trimester of pregnancy; there are
D. Rodger
hundreds of thousands of individuals or couples willing to adopt; foetal transfer surgery
turns out to be low risk and without much inconvenience; restrictions to legal abortion
are implemented in several countries; and there is both the technological and medical
capacities to support hundreds of thousands of gestatelings each year. On balance, I
think each of the scenarios I have described is unlikely to materialise to the scale
required to radically transform the problem of abortion.
4 A New Problem: Gestaticide
A further issue raised by transferring pregnanciesto an artificial womb is that it
means creating a new category of killing—gestaticide (Rodger et al. 2020). Gestaticide
describes the deliberate killing of the subject of an artificial womb. It has long been the
case that some philosophers have argued that infanticide is morally permissible, and
arguments that justify infanticide are likely to also apply to the gestateling. As both are
independent of the mother, the case for infanticide and gestaticide must be made on
grounds other than bodily autonomy. Peter Singer (2011) has argued that because
infants lack characteristics such as rationality, autonomy and self-awareness, then
killing them cannot be considered the moral equivalent of killing a human that does
possess these characteristics. On such accounts the newborn, like the foetus—and
gestateling—should not be understood as persons with a corresponding right to life.5
Therefore, fewer reasons would be needed to justify killing them compared to an
individual who possesses the characteristics necessary to have a right to life. Similar
arguments have been put forward by other philosophers such as Michael Tooley
(1983), Nicole Hassoun and Uriah Kriegel (2008), and Alberto Giubilini and Francesca
Minerva (2013).6 So, even if we accept that there is no right to the death of the foetus—
whilst in utero—this may only result in a new ethical debate surrounding the permis-
sibility of gestaticide—which will conceptually resemble the ethical debate surrounding
the permissibility of infanticide rather than abortion.
5 Conclusion
In summary, I have argued that even if ectogestation becomes possible, this is unlikely
to transform the abortion debate. Unless the presence of ectogestation is conjoined with
significant abortion restrictions, women are unlikely to opt for ectogestation for the
same or similar reasons that they rarely opt to give their child up for adoption.
Moreover, the additional stigma created by not using ectogestation is unlikely to be
significant enough to modify behaviour to the extent required to transform the problem
of abortion. Finally, assuming women were to transfer their unintended pregnancies to
an artificial womb for ectogestation, this would simply generate debate concerning a
new category of killing—gestaticide. Rather than ending the debate around abortion, it
5 For a discussion of moral status and the relevance of birth, see Colgrove (2019); Romanis (2019); and
Colgrove (2020).
6 More recently defended by Räsänen (2016).
Why Ectogestation Is Unlikely to Transform the Abortion Debate: a…
may only reorient it to whether—or when—it is permissible to kill humans undergoing
artificial gestation.
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References
Aiken, A. R. A., & Bloomer, F. (2019). Abortion decriminalised in Northern Ireland. BMJ, 367, l6330. https://
doi.org/10.1136/bmj.l6330.
Bearak, J., Popinchalk, A., Ganatra, B., Moller, A.-B., Tunçalp, Ö., Beavin, C., et al. (2020). Unintended
pregnancy and abortion by income, region, and the legal status of abortion: estimates from a compre-
hensive model for 1990–2019. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(20)
30315-6.
Biggs, M. A., Brown, K., & Foster, D. G. (2020). Perceived abortion stigma and psychological well-being
over five years after receiving or being denied an abortion. PLoS One, 15(1), e0226417. https://doi.org/
10.1371/journal.pone.0226417.
Blackshaw, B. P., & Rodger, D. (2019). Ectogenesis and the case against the right to the death of the foetus.
Bioethics, 33(1), 76–81. https://doi.org/10.1111/bioe.12529.
Blackshaw, B. P., & Rodger, D. (2020). Questionable benefits and unavoidable personal beliefs: defending
conscientious objection for abortion. Journal of Medical Ethics, 46, 178–182. https://doi.org/10.1136/
medethics-2019-105566.
Cannold, L. (1995). Women, ectogenesis and ethical theory. Journal of Applied Philosophy, 12(1), 55–64.
https://doi.org/10.1111/j.1468-5930.1995.tb00119.x.
Cárdenas, R., Labandera, A., Baum, S. E., et al. (2018). “It’s something that marks you”: abortion stigma after
decriminalization in Uruguay. Reproductive Health, 15, 150. https://doi.org/10.1186/s12978-018-0597-1.
Colgrove, N. (2019). Subjects of ectogenesis: are ‘gestatelings’ fetuses, newborns or neither? Journal of
Medical Ethics, 45, 723–726. https://doi.org/10.1136/medethics-2019-105495.
Colgrove, N. (2020). Artificial wombs, birth and ‘birth’: a response to Romanis. Journal of Medical Ethics,
46, 554–556. https://doi.org/10.1136/medethics-2019-105845.
Finer, L. B., Frohwirth, L. F., Dauphinee, L. A., Singh, S., & Moore, A. M. (2005). Reasons U.S. women have
abortions: quantitative and qualitative perspectives. Perspectives on Sexual and Reproductive Health,
37(3), 110–118. https://doi.org/10.1111/j.1931-2393.2005.tb00045.x.
Giubilini, A., & Minerva, F. (2013). After-birth abortion: why should the baby live? Journal of Medical
Ethics, 39, 261–263. https://doi.org/10.1136/medethics-2011-100411.
Guillaume, A., & Rossier, C. (2018). Abortion around the world: an overview of legislation, measures, trends,
and consequences, transl. P Reeve. Population, 73, 271–306.
Hassoun, N., & Kriegel, U. (2008). Consciousness and the moral permissibility of infanticide. Journal of
Applied Philosophy, 25, 45–55. https://doi.org/10.1111/j.1468-5930.2008.00392.x.
Hendricks, P. (2018). There is no right to the death of the fetus. Bioethics, 32(6), 395–397. https://doi.org/10.
1111/bioe.12455.
Jones, R. K., Frohwirth, L. F., & Moore, A. M. (2008). “I would want to give my child, like, everything in the
world”: how issues of motherhood influence women who have abortions. Journal of Family Issues, 29(1),
79–99. https://doi.org/10.1177/0192513X07305753.
Kaczor, C. (2018). Ectogenesis and a right to the death of the prenatal human being: a reply to Räsänen.
Bioethics, 32(9), 634–638. https://doi.org/10.1111/bioe.12512.
Mathison, E., & Davis, J. (2017). Is there a right to the death of the foetus? Bioethics, 31(4), 313–320. https://
doi.org/10.1111/bioe.12331.
D. Rodger
National Institute for Health and Care Excellence. (2019). Abortion before 14 weeks: choosing between
medical or surgical abortion Decision aid. https://www.nice.org.uk/guidance/ng140/resources/abortion-
before-14-weeks-choosing-between-medical-or-surgical-abortion-patient-decision-aid-pdf-6906582255.
Accessed 6 Oct 2020.
Partridge, E. A., Davey, M. G., Hornick, M. A., Homick, M., et al. (2017). An extra-uterine system to
physiologically support the extreme premature lamb. Nature Communications, 8, 1–15. https://doi.org/10.
1038/ncomms15112.
Popinchalk, A., & Sedgh, G. (2019). Trends in the method and gestational age of abortion in high-income
countries. BMJ Sexual & Reproductive Health, 45, 95–103. https://doi.org/10.1136/bmjsrh-2018-200149.
Räsänen, J. (2016). Pro-life arguments against infanticide and why they are not convincing. Bioethics, 30(9),
656–662. https://doi.org/10.1111/bioe.12281.
Räsänen, J. (2017). Ectogenesis, abortion and a right to the death of the fetus. Bioethics, 31(9), 697–702.
https://doi.org/10.1111/bioe.12404.
Rodger, D., Colgrove, N., & Blackshaw, B. P. (2020). Gestaticide: killing the subject of the artificial womb.
Journal of Medical Ethics. http://dx.doi.org/10.1136/medethics-2020-106708
Romanis, E. C. (2018). Artificial womb technology and the frontiers of human reproduction: conceptual
differences and potential implications. Journal of Medical Ethics, 44(11), 751–755. https://doi.org/10.
1136/medethics-2018-104910.
Romanis, E. C. (2019). Artificial womb technology and the significance of birth: why gestatelings are not
newborns (or fetuses). Journal of Medical Ethics, 45, 728–731. https://doi.org/10.1136/medethics-2019-
105723.
Romanis, E. C., Begović, D., Brazier, M. R., et al. (2020). Reviewing the womb. Journal of Medical Ethics.
https://doi.org/10.1136/medethics-2020-106160.
Sedgh, G., Bearak, J., Singh, S., et al. (2016). Abortion incidence between 1990 and 2014: global, regional,
and subregional levels and trends. Lancet, 388, 258–267. https://doi.org/10.1016/S0140-6736(16)30380-
4.
Simonstein, F., & Mashiach-Eizenberg, M. (2009). The artificial womb: a pilot study considering people’s
views on the artificial womb and ectogenesis in Israel. Cambridge Quarterly of Healthcare Ethics, 18(1),
87–94. https://doi.org/10.1017/s0963180108090130.
Singer, P. (2011). Practical ethics (3rd ed.). Cambridge: Cambridge University Press.
Sisson, G., Ralph, L., Gould, H., & Foster, D. G. (2017). Adoption decision making among women seeking
abortion. Women’s Health Issues, 27(2), 136–144. https://doi.org/10.1016/j.whi.2016.11.007.
Stratman, C. M. (2020). Ectogestation and the problem of abortion. Philosophy and Technology. https://doi.
org/10.1007/s13347-020-00427-2.
Tooley, M. (1983). Abortion and infanticide. Oxford: Oxford University Press.
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Why Ectogestation Is Unlikely to Transform the Abortion Debate: a…
- Why Ectogestation Is Unlikely to Transform the Abortion Debate: a Discussion of ‘Ectogestation and the Problem of Abortion’
- Abstract
- Introduction
- Adoption, Harm and Stigma
- Problems That Must Be Overcome
- A New Problem: Gestaticide
- Conclusion
- References