Nancy Jecker discusses how four principles guide a bioethical approach to abortion care: respecting a patents’ autonomy, nonmaleficence, beneficence and justice. She examines how these four principles are used by doctors and bioethicists, and how settling legal controversies regarding abortion will require reaching moral consensus.
The ethical principle of autonomy states that patients are entitled to make decisions about their own medical care when able. The American Medical Association’s Code of Medical Ethics recognizes a patient’s right to “receive information and ask questions about recommended treatments” in order to “make well-considered decisions about care.” Respect for autonomy is enshrined in laws governing informed consent, which protect patients’ right to know the medical options available and make an informed voluntary decision.
Some bioethicists regard respect for autonomy as lending firm support to the right to choose abortion, arguing that if a pregnant person wishes to end their pregnancy, the state should not interfere. According to one interpretation of this view, the principle of autonomy means that a person owns their body and should be free to decide what happens in and to it.
Abortion opponents do not necessarily challenge the soundness of respecting people’s autonomy, but may disagree about how to interpret this principle. Some regard a pregnant person as “two patients” – the pregnant person and the fetus.
One way to reconcile these views is to say that as an immature human being becomes “increasingly self-conscious, rational and autonomous it is harmed to an increasing degree,” as philosopher Jeff McMahan writes. In this view, a late-stage fetus has more interest in its future than a fertilized egg, and therefore the later in pregnancy an abortion takes place, the more it may hinder the fetus’s developing interests. In the U.S., where 92.7% of abortions occur at or before 13 weeks’ gestation, a pregnant person’s rights may often outweigh those attributed to the fetus. Later in pregnancy, however, rights attributed to the fetus may assume greater weight. Balancing these competing claims remains contentious.
Read the entire article on The Conversation, “Abortion and bioethics: Principles to guide U.S. abortion debates.”