Targeting the Fetal Body and/or Mother–Child Connection: Vital Conflicts and Abortion

Abstract

Is the “act itself” of separating a pregnant woman and her previable child neither good nor bad morally, considered in the abstract? Recently, Maureen Condic and Donna Harrison have argued that such separation is justified to protect the mother’s life and that it does not constitute an abortion as the aim is not to kill the child. In our article on maternal–fetal conflicts, we agree there need be no such aim to kill (supplementing aims such as to remove). However, we argue that to understand “abortion” as performed only where the death of the child is intended is to define the term too narrowly. Respect for the mother, the fetus, and the bond between them goes well beyond avoiding any such aim. We distinguish between legitimate maternal treatments simply aimed at treating or removing a damaged part of the woman and illegitimate treatments that focus harmfully on the fetal body and its presence within the mother’s body. In obstetrics as elsewhere, not all side effects for one subject of intervention can be outweighed by intended benefits for another. Certain side effects of certain intended interventions are morally conclusive. Summary: How should one respond to “vital conflicts” in pregnancy where the mother’s life or health is at risk? We argue that, in addition to avoiding any aim of ending life, one must avoid the similarly unacceptable aims of evicting the baby pre-viability and invading its body, including its placenta, in a lethally harmful way. Even at the cost of real and important benefits for the mother such as increased safety and protection of fertility, we must manage cases always in a way that respects the inviolable bodily rights of both mother and child and crucially, the unique bond between them.

Double-Effect Donation or Bodily Respect? A “Third Way” Response to Camosy and Vukov

“…We have argued elsewhere (McCarthy 2015; Watt and McCarthy 2020) for the existence of what we call “unintended morally determinative aspects” of an action, or UMDAs for short. Such unintended but nonetheless crucial features can include even the innocence of the victim in a murder case: most murderers do not kill people because they are innocent, even if they kill in full awareness of, or indifferent to, the innocence of their victims.…”

Do Fetuses Have the Same Interests as Their Mothers?

“…37 For an exploration of various responses to "vital conflicts" in pregnancy, see Watt and McCarthy 2020. Whatever applies in these exceptionally fraught situations, at the very least in other cases where the reason for intervening is "merely" social, lethal separations would seem to be morally excluded if mother and fetus are both human subjects with morally considerable interests.…”

“…39 Note that this could go both ways: immediate help for the fetus might involve an immoral (because seriously harmful and/or unwanted) surgical invasion of the mother, just as the body of the fetus might be wrongly targeted for the intended benefit of the woman. Bodily targeting of innocent human beings, including omissions aimed at bodily effects intended and/or known to be seriously harmful (Watt and McCarthy 2020) must be separated from acts and omissions not involving such targeting.…”

Double Effect Donation

“…There are those who object to the kind of argument we are making on a slightly different ground, however. Watt and McCarthy (2019), for instance, argue that in some circumstances, matters related to the moral act beyond the intention can be decisive for the moral nature of an act (Watt & McCarthy 2019). While Watt and McCarthy’s (2019) discussion centers on abortion, their central claim is general one:…it is wrong to treat all unintended side-effects as if they were “mere” side-effects which sufficiently good intended outcomes could in principle outweigh.…”

“…Watt and McCarthy (2019), for instance, argue that in some circumstances, matters related to the moral act beyond the intention can be decisive for the moral nature of an act (Watt & McCarthy 2019). While Watt and McCarthy’s (2019) discussion centers on abortion, their central claim is general one:…it is wrong to treat all unintended side-effects as if they were “mere” side-effects which sufficiently good intended outcomes could in principle outweigh. Rather, some side-effects or aspects of human actions are morally conclusive when combined with some intentions… [Acknowledging this reality is] crucial in evaluating human acts, both in and outside medicine, perhaps especially those which focus on the bodies of young/otherwise innocent human beings.…”