Maternal Health Care: A Question of Ethics

In the debate on abortion funding, one's stance on the issue is a question of ethics.

Canada’s choice not to fund abortions with foreign aid dollars isn’t about keeping women in their place, it’s an ethical decision to value human life.

Whether abortion should or should not be funded as part of the proposed “G8 maternal and child health initiative” is currently the focus of conflict. That conflict encompasses issues that include what is required in order to respect women and their rights; what is needed to protect and promote women and children’s health; and how we should view fetuses/unborn children, especially in the context of becoming complicit in abortion by funding it.

“Reproductive rights advocates” such as Jane Cawthorne, author of the play The Abortion Monologues, like many feminists, make the litmus test of respect for women that of not placing restrictions on abortion and, as in the case of the “maternal and child health initiative,” making it available by funding it. Writing in the Globe and Mail, Cawthorne accuses the Conservative government of defining “good” women as traditional women – women who are mothers, nurturing, submissive, and married – and describes such a view as “the last vestiges of ... outdated ideas” and disrespectful of women. She argues that “by refusing to fund abortions as part of its ill-conceived maternal health initiative, the Conservative government is effectively saying only women who become mothers are worthy of complete health care.”

In response to her claims, we should first note that this initiative is specifically for “maternal and child health,” not just women. Otherwise we would have strong reasons to ask whether we were unjustly discriminating against men, as compared with women, in excluding them.

Then, we need to consider the claim that abortion is properly characterized as health care. Pro-choice supporters characterize it in that way in all circumstances. In very rare cases that could be correct, but the vast majority of abortions are not undertaken for medical reasons.

One reason pro-choice and pro-life adherents view abortion differently is that they view the nature of the fetus/unborn child differently. Many who are pro-choice see it as tissue that is part of the woman’s body until it is born. They believe the woman is entitled to have it removed. Those who are pro-life see it as a new human life, a human being with the full potential already present to develop through all the later stages of life, if it is allowed to do so. Obviously, these two views lead to very different conclusions about the acceptability of abortion.

Contrasting two different models of how we see the development of a fetus might also provide further insights about how our perceptions of the fetus/unborn child and, as a result, views about abortion differ. American law professor Richard Stith proposes that under a “construction model,” the fetus is seen as being “constructed” and the maker – the woman – can decide to stop construction, just as she could if she were building a house, for example. This is a model that adopts the view that, at least up to a certain point, the new person is not there.

In contrast, in a “development model,” the unborn child is seen to have its full potential to develop throughout its future life already present at conception and the woman makes possible the conditions – conditions that every human being has needed at this earliest stage of life – that are required for it to do so. This is a model of “continual presence, but gradual appearance” of the person.

The values focus of those who support funding abortion and those who do not also differs. Pro-choice adherents focus on the woman and her rights to have control over her own body, her rights to autonomy and self-determination. Pro-life adherents focus on the unborn child’s right to life and the breach of the value of respect for all human life, in general, that abortion entails. In prioritizing these conflicting values, each side chooses differently.

Finally, as has been the case with other pro-choice advocates in this “maternal and child health initiative” debate, Michael Ignatieff being one example, Cawthorne alleges that “the maternal health initiative (in not funding abortion) facilitates ideology, not health.” She is wrong about the health goal. There is such a vast need in this regard that, provided it’s not sabotaged by the abortion issue, the initiative can’t help but achieve much desperately needed good; that we can all agree on.

Moreover, we should keep in mind that even so-called “safe” abortion involves risks and harms, especially in developing countries, which often have minimal or no adequate health-care resources. Pro-choice adherents are reluctant, at best, to acknowledge these risks and harms. And most people agree abortion should not be used as a form of birth control. There is a high risk of its being used as such in developing countries.

It’s true, as Cawthorne says, that the “initiative facilitates ideology,” but that’s the case whether or not it includes funding for abortion. The pro-choice arguments for funding abortion are just as much based on an ideology – a set of values and beliefs – as the pro-life ones against funding it are.

Obviously each of us must choose one or the other position. I propose that in doing so, we must try to place abortion in a moral context and always see it as a major ethical decision, whether it involves ourselves or our cooperation in providing it for others. My hope is that most Canadians would decide against it.

This article was originally published in the Ottawa Citizen.