Why We Should Stop Using the Term “Elective Abortion”

Abstract

In abortion care, the term "elective" is often used as a moral judgment that determines which patients are entitled to care. Secular health care organizations that attempt to avoid controversy by allowing "therapeutic" but not "elective" abortions are using medical terminology to reinforce regressive social norms concerning motherhood and women's sexuality because what distinguishes pregnant women with medical indications for abortion is that they originally wanted to become mothers or, in cases of rape, that they did not consent to sex. Secular health care organizations should stop denying the moral agency of patients and physicians who conclude abortion is morally acceptable and should only use the word elective when billing codes require it. Regardless of reason, the proper label for all abortion is health care. The Term "Elective" as a Label My stepfather recently had elective surgery-a classic case of knee replacement on demand. Tom wanted to reverse the perfectly natural physical change of eroded cartilage (exacerbated by his choice to play squash for pleasure), so he went to a physician who agreed with his value-laden rejection of how using a wheelchair would change his life. Insurance paid for this elective procedure because his physician recommended it, but that recommendation was simply confirmation that a safe medical procedure could return Tom's body and life to what he previously experienced as his baseline state.

Abortion Access and Medically Complex Pregnancies Before and After Texas Senate Bill 8

“…Ethics scholars have noted that establishing criteria around which abortions are medically indicated compared with not is arbitrary. 2,3,24,25 These arbitrary criteria—in conjunction with often cumbersome administrative procedures to allow even indicated abortions—could put patients’ health at risk, as cases described in our data reveal. This has worsened after implementation of SB8, as shown here and in a case series of patients with previable PROM who were expectantly managed rather than immediately induced, resulting in significant maternal morbidity and expected fetal loss.…”

The ‘Institutional Lottery’: Institutional variation in the processes involved in accessing late abortion in Victoria, Australia

“…Participants described that most non-religiously affiliated public health services in Victoria made policy decisions to not offer late abortions for psychosocial reasons, limiting the availability of late abortions to fetal abnormalities (and psychiatric cases in some circumstances). Such a bifurcation reflects a perennial tendency (which is not limited to the Australian context) to preference ‘medical’ or ‘fetal grounds’ over other reasons for seeking abortion, despite such a distinction not being reflected in law ( Kimport et al, 2016 ; Watson, 2018 ). The differential treatment of abortions based on the grounds the abortion was being sought is hard to justify clinically given the abortion is not necessarily performed differently.…”

“…Rather such a distinction seems to reflect a moral judgement on a patient's reasoning for undergoing an abortion masquerading as medical discretion. This type of medical practice perpetuates stigma associated with abortions sought on psychosocial grounds and significantly disadvantages patients who are often already facing challenges that contributed to the need for a late abortion ( Erdman, 2017 ; Watson, 2018 ). Such a dichotomy is also hard to justify from an ethical perspective with some ethicists arguing that there is no ethical basis to this distinction ( Savulescu, 2001 ).…”

Centrality of Pregnancy and Prenatal Attachment in Pregnant Nulliparous After Recent Elective or Therapeutic Abortion

“…This distinguishes it from therapeutic abortion, a procedure induced for medical reasons, such as to protect the mother's health. Although a great debate exists about the fact that terminology and labels are extremely linked to moral judgment ["medical vs. elective is code for morally justified vs. morally unjustified (Janiak and Goldberg, 2016), as decided by someone other than the patient and her physician" (Watson, 2018(Watson, , p. 1177], in the absence of a new terminology, we choose to maintain "elective abortion" to define the pregnancy interruption for reasons other than medical.…”