August 3, 2018 in Medicine
Abortion: Controversial Question of the Day

Today, abortion  is one of the most discussed and controversial issues facing the world. Society can not find common ground and reach an agreement in solving this problem because of the diversity of nationalities, cultures, and religions.

Since the beginning of XX century till now, the issue of the legalization of abortion has been the cause for panel discussions, citizens demonstrations, and parliament hearings. The severity of the discussing of abortion problems persists despite the fact that this problem is definitely not new. Historically, the attitude of doctors to abortion is one of the first and fundamental ethical and medical issues that are still relevant today. This is explained by the fact that the problem of abortion concentrates on the relationship between people at the level of moral, legal, social, political, religious, and scientific consciousness. Considering the problem of abortion in each of these levels, one can answer the question why it is a basic and fundamental problem of modern biomedical ethics.

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In 1994, the Cairo International Conference on Population of UN of 179 countries adopted a 20-year Programme of Action, which identified priority needs of people and not the achievement of demographic indicators. This policy document first pointed out the incompatibility of the decision-making with discrimination, coercion, or violence in the field of reproductivity. Moreover, exactly at this conference, it was recognized that the implementation of reproductive rights is impossible without the development of mutually respectful and equitable gender relations.

UN position on abortion is: “Most abortions can be prevented through proper planning of the family, but sometimes defects of contraceptives, unfortunately, lead to unwanted pregnancies. Therefore, women will continue to seek help from an interrupt – this is the reality. No matter if abortion is allowed in the country or not, the woman should receive medical care for complications of abortion” (Adams, 1997).

Programme of Action and the recommendations of international organizations have been made, accepted, and ratified, but a complete strategy of their implementation and the way of monitoring their implementation remaine unclear.

In contrast to  the governments of many European countries, which are guided by the understanding that the free determination of the number of children is the right of every person and forcing turns problems for women and children, the governments of several Asian countries and the former Soviet republics linked demographic problems solving to the implementation of programs of demographic security, which aims to increase the birth rate in the country through the state concern about families raising two or more children. For comparison, in western Europe, the issues of family policy is not only directly assisting families, but is also increasing income and gender equality and reducing income inequality.

In Western Europe, where the situation is most favorable for abortion, the rate of them is the lowest. In addition, in Central and Eastern Europe, there is a rapid decline in abortions among young people. Compared with other regions of the world, the number of abortions in Western Europe is very low, about 12 per 1,000 women of reproductive age (De Miranda, 2004). One of the most important prerequisites for this is sex education.

Speaking about the attitude toward abortion in various countries and regions of the world, one should mention the relation of religion to the issue, taking into account the differences between religions and cultures in different countries and regions.

All religions see an embryo as a man and consider abortion as murder regardless of the term of pregnancy. Religious leaders try to influence the legislative regulation of the right to abortion.

The supporters of the ban on abortions cite embryology data which show that since the merger of male and female germ cells in the vial maternal fallopian tube embryo has many of the characteristics of human beings, in particular genome, which is directed at the gradual development until the formation of the adult. These supporters of abortion ban conclude that the embryo can be already considered as a person (Hoffman & Miller, 1997).

As for the position of the Orthodox Church, its canons equate abortion to a murder. At the heart of this assessment is the belief that the conception of the human being is a gift from God. That is why, from the moment of conception, every infringement on the life of the future person is criminal.

The catechism of the Catholic Church states: “From the beginning, the embryo must be honored for a person”. Official documents of the Roman Catholic Church prohibit abortion even for health reasons.

In the Protestant churches, abortion is condemned as a means of birth control, but is allowed in exceptional situation such as pregnancy after rape.

In “Islamic Code of Medical Ethics” (Kuwait, 1981), current trends of allowing an abortion are condemned. According to some Muslim authors, human embryo takes shape at 3-4 months of pregnancy, which is why in exceptional cases and with the consent of both spouses, abortion is acceptable with a little pregnancy.

According to Buddhism, killing means commitment of the worst negative thing. The ethics of Buddhism begins with the commandments like: “Do not take anyone’s life, whether human or animal” and “The embryo is sacred and has the potential of human beings”. Therefore, abortion is the annihilation of life at any stage.

Authorities of Judaism consider that abortion (and in general – not wanting to have children) contradicts history and messianic destiny of the Jewish people. At the same time, one of the most respected scholars of Jewish, physician Maimonides, taught not to spare the striker. Referring to this principle, Dr. Shabad allowed killing of the unborn child if the pregnancy threats physical or mental health of woman (Petersen, 2001).

 The conflict between the religious and secular ideology, which became a landmark event in the socio-historical development of the post-industrial Western civilization, is especially vividly manifested in the United States. This is largely due to the fact that a large part of American society continues to adhere to conservative religious values and, as a consequence, the resistance is trying to hostile secular trends. A case in point as a debate over the legalization of abortion can serve as an example  not only by the annual marches “for life”, but also numerous attempts to block the activities of clinics where abortions are made, and even armed attacks on them.

Since 1988, under public pressure, most hospitals refuse to perform abortions except some complex cases. It is already hard to find doctors practicing abortions in the United States. In the states of North and South Dakota, for example, there are only two of them. Teaching of abortion techniques is almost not implemented. So the officials who are responsible for medical training had to turn to universities to include techniques of abortion in the training too. Even with a sharp decrease in the number of performed operations, there remains a need for them in the emergency room or a premature birth.

Meanwhile, the most radical abortion-fighters continue their crusade. One of the organizations, American Coalition of Life activists, released a list of Deadly Dozen, consisting of the names of 12 doctors, “who are responsible for the murder of young children”. Federal authorities have been forced to give police protection to each of the doctors (Maxwell, 2002).

However, with all the variety of points of view on this issue, it can be divided into three directions (Wlezien & Malcolm, 1993). With the so-called “liberal” point of view “to the moment of natural birth a woman has the right to decide on abortion, the doctor is obliged to ensure the implementation of this right. Unborn fetus is not recognized in any sense of the human person, and is not, therefore, a member of the moral community. On the unborn fetus the right to life does not extend and, therefore, it does not have the quality that would oblige the other to refrain from acts which cease its existence”  This position mainly fits the most emancipated women as well as the representatives of the International Planned Parenthood Federation, for which abortion is a means of birth control.

Another point of view is directly opposed to the first. Abortion cannot have a moral justification, and it is seen as a direct murder. From the moment of conception, embryo is seen as a person who should be given the bulk of human rights, especially the right to life. This position is shared by many leading scientists (Professor Bernard Nathanson, a French geneticist Dr. Jerome Lejeune, a geneticist Ashley Montagu, Russian geneticists D. Popov, V.A. Golichenkov and many others).

Finally, the so-called “moderate” position approves gradual animation of the embryo and its acquisition of human and personal properties in the process of development from conception to birth. This is point of view of so-called “soft” supporters of abortion. This latter position is the most controversial and confusing, because different representatives offer a variety of criteria to determine the date or period of development after which a human embryo, acquiring the status of man, is also the subject of moral relations. Interestingly, none of the criteria (or a certain set of them) does not provide a basis on which the logical definition of the moral status of the embryo could be built. Many researchers hold that position precisely because of its “moderation”. In practice, though, it is not applicable because of its vagueness. Therefore, the chaos regarding this question, which is now both in science and medicine, is on its conscience. Still, some thinkers believe that it is impossible in this case to develop a generic approach to the problem by coming to any final justification of the values, norms, and virtues. It is just needed to quickly agree on what should be constituted moral and immoral.


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