abortion is wrong thesis

• Share full article

Advertisement

Supported by

Ross Douthat

The Case Against Abortion

By Ross Douthat

Opinion Columnist

A striking thing about the American abortion debate is how little abortion itself is actually debated. The sensitivity and intimacy of the issue, the mixed feelings of so many Americans, mean that most politicians and even many pundits really don’t like to talk about it.

The mental habits of polarization, the assumption that the other side is always acting with hidden motives or in bad faith, mean that accusations of hypocrisy or simple evil are more commonplace than direct engagement with the pro-choice or pro-life argument.

And the Supreme Court’s outsize role in abortion policy means that the most politically important arguments are carried on by lawyers arguing constitutional theory, at one remove from the real heart of the debate.

But with the court set this week to hear Dobbs v. Jackson Women’s Health Organization, a direct challenge to Roe v. Wade, it seems worth letting the lawyers handle the meta-arguments and writing about the thing itself. So this essay will offer no political or constitutional analysis. It will simply try to state the pro-life case.

At the core of our legal system, you will find a promise that human beings should be protected from lethal violence. That promise is made in different ways by the Constitution and the Declaration of Independence; it’s there in English common law, the Ten Commandments and the Universal Declaration of Human Rights. We dispute how the promise should be enforced, what penalties should be involved if it is broken and what crimes might deprive someone of the right to life. But the existence of the basic right, and a fundamental duty not to kill, is pretty close to bedrock.

We are having trouble retrieving the article content.

Please enable JavaScript in your browser settings.

Thank you for your patience while we verify access. If you are in Reader mode please exit and  log into  your Times account, or  subscribe  for all of The Times.

Thank you for your patience while we verify access.

Already a subscriber?  Log in .

Want all of The Times?  Subscribe .

The Most Important Study in the Abortion Debate

Researchers rigorously tested the persistent notion that abortion wounds the women who seek it.

The demographer Diana Greene Foster was in Orlando last month, preparing for the end of Roe v. Wade , when Politico published a leaked draft of a majority Supreme Court opinion striking down the landmark ruling. The opinion, written by Justice Samuel Alito, would revoke the constitutional right to abortion and thus give states the ability to ban the medical procedure.

Foster, the director of the Bixby Population Sciences Research Unit at UC San Francisco, was at a meeting of abortion providers, seeking their help recruiting people for a new study . And she was racing against time. She wanted to look, she told me, “at the last person served in, say, Nebraska, compared to the first person turned away in Nebraska.” Nearly two dozen red and purple states are expected to enact stringent limits or even bans on abortion as soon as the Supreme Court strikes down Roe v. Wade , as it is poised to do. Foster intends to study women with unwanted pregnancies just before and just after the right to an abortion vanishes.

Read: When a right becomes a privilege

When Alito’s draft surfaced, Foster told me, “I was struck by how little it considered the people who would be affected. The experience of someone who’s pregnant when they do not want to be and what happens to their life is absolutely not considered in that document.” Foster’s earlier work provides detailed insight into what does happen. The landmark Turnaway Study , which she led, is a crystal ball into our post- Roe future and, I would argue, the single most important piece of academic research in American life at this moment.

The legal and political debate about abortion in recent decades has tended to focus more on the rights and experience of embryos and fetuses than the people who gestate them. And some commentators—including ones seated on the Supreme Court—have speculated that termination is not just a cruel convenience, but one that harms women too . Foster and her colleagues rigorously tested that notion. Their research demonstrates that, in general, abortion does not wound women physically, psychologically, or financially. Carrying an unwanted pregnancy to term does.

In a 2007 decision , Gonzales v. Carhart , the Supreme Court upheld a ban on one specific, uncommon abortion procedure. In his majority opinion , Justice Anthony Kennedy ventured a guess about abortion’s effect on women’s lives: “While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained,” he wrote. “Severe depression and loss of esteem can follow.”

Was that really true? Activists insisted so, but social scientists were not sure . Indeed, they were not sure about a lot of things when it came to the effect of the termination of a pregnancy on a person’s life. Many papers compared individuals who had an abortion with people who carried a pregnancy to term. The problem is that those are two different groups of people; to state the obvious, most people seeking an abortion are experiencing an unplanned pregnancy, while a majority of people carrying to term intended to get pregnant.

Foster and her co-authors figured out a way to isolate the impact of abortion itself. Nearly all states bar the procedure after a certain gestational age or after the point that a fetus is considered viable outside the womb . The researchers could compare people who were “turned away” by a provider because they were too far along with people who had an abortion at the same clinics. (They did not include people who ended a pregnancy for medical reasons.) The women who got an abortion would be similar, in terms of demographics and socioeconomics, to those who were turned away; what would separate the two groups was only that some women got to the clinic on time, and some didn’t.

In time, 30 abortion providers—ones that had the latest gestational limit of any clinic within 150 miles, meaning that a person could not easily access an abortion if they were turned away—agreed to work with the researchers. They recruited nearly 1,000 women to be interviewed every six months for five years. The findings were voluminous, resulting in 50 publications and counting. They were also clear. Kennedy’s speculation was wrong: Women, as a general point, do not regret having an abortion at all.

Researchers found, among other things, that women who were denied abortions were more likely to end up living in poverty. They had worse credit scores and, even years later, were more likely to not have enough money for the basics, such as food and gas. They were more likely to be unemployed. They were more likely to go through bankruptcy or eviction. “The two groups were economically the same when they sought an abortion,” Foster told me. “One became poorer.”

Read: The calamity of unwanted motherhood

In addition, those denied a termination were more likely to be with a partner who abused them. They were more likely to end up as a single parent. They had more trouble bonding with their infants, were less likely to agree with the statement “I feel happy when my child laughs or smiles,” and were more likely to say they “feel trapped as a mother.” They experienced more anxiety and had lower self-esteem, though those effects faded in time. They were half as likely to be in a “very good” romantic relationship at two years. They were less likely to have “aspirational” life plans.

Their bodies were different too. The ones denied an abortion were in worse health, experiencing more hypertension and chronic pain. None of the women who had an abortion died from it. This is unsurprising; other research shows that the procedure has extremely low complication rates , as well as no known negative health or fertility effects . Yet in the Turnaway sample, pregnancy ended up killing two of the women who wanted a termination and did not get one.

The Turnaway Study also showed that abortion is a choice that women often make in order to take care of their family. Most of the women seeking an abortion were already mothers. In the years after they terminated a pregnancy, their kids were better off; they were more likely to hit their developmental milestones and less likely to live in poverty. Moreover, many women who had an abortion went on to have more children. Those pregnancies were much more likely to be planned, and those kids had better outcomes too.

The interviews made clear that women, far from taking a casual view of abortion, took the decision seriously. Most reported using contraception when they got pregnant, and most of the people who sought an abortion after their state’s limit simply did not realize they were pregnant until it was too late. (Many women have irregular periods, do not experience morning sickness, and do not feel fetal movement until late in the second trimester.) The women gave nuanced, compelling reasons for wanting to end their pregnancies.

Afterward, nearly all said that termination had been the right decision. At five years, only 14 percent felt any sadness about having an abortion; two in three ended up having no or very few emotions about it at all. “Relief” was the most common feeling, and an abiding one.

From the May 2022 issue: The future of abortion in a post- Roe America

The policy impact of the Turnaway research has been significant, even though it was published during a period when states have been restricting abortion access. In 2018, the Iowa Supreme Court struck down a law requiring a 72-hour waiting period between when a person seeks and has an abortion, noting that “the vast majority of abortion patients do not regret the procedure, even years later, and instead feel relief and acceptance”—a Turnaway finding. That same finding was cited by members of Chile’s constitutional court  as they allowed for the decriminalization of abortion in certain circumstances.

Yet the research has not swayed many people who advocate for abortion bans, believing that life begins at conception and that the law must prioritize the needs of the fetus. Other activists have argued that Turnaway is methodologically flawed; some women approached in the clinic waiting room declined to participate, and not all participating women completed all interviews . “The women who anticipate and experience the most negative reactions to abortion are the least likely to want to participate in interviews,” the activist David Reardon argued in a 2018 article in a Catholic Medical Association journal.

Still, four dozen papers analyzing the Turnaway Study’s findings have been published in peer-reviewed journals; the research is “the gold standard,” Emily M. Johnston, an Urban Institute health-policy expert who wasn’t involved with the project, told me. In the trajectories of women who received an abortion and those who were denied one, “we can understand the impact of abortion on women’s lives,” Foster told me. “They don’t have to represent all women seeking abortion for the findings to be valid.” And her work has been buttressed by other surveys, showing that women fear the repercussions of unplanned pregnancies for good reason and do not tend to regret having a termination. “Among the women we spoke with, they did not regret either choice,” whether that was having an abortion or carrying to term, Johnston told me. “These women were thinking about their desires for themselves, but also were thinking very thoughtfully about what kind of life they could provide for a child.”

The Turnaway study , for Foster, underscored that nobody needs the government to decide whether they need an abortion. If and when America’s highest court overturns Roe , though, an estimated 34 million women of reproductive age will lose some or all access to the procedure in the state where they live. Some people will travel to an out-of-state clinic to terminate a pregnancy; some will get pills by mail to manage their abortions at home; some will “try and do things that are less safe,” as Foster put it. Many will carry to term: The Guttmacher Institute has estimated that there will be roughly 100,000 fewer legal abortions per year post- Roe . “The question now is who is able to circumvent the law, what that costs, and who suffers from these bans,” Foster told me. “The burden of this will be disproportionately put on people who are least able to support a pregnancy and to support a child.”

Ellen Gruber Garvey: I helped women get abortions in pre- Roe America

Foster said that there is a lot we still do not know about how the end of Roe might alter the course of people’s lives—the topic of her new research. “In the Turnaway Study, people were too late to get an abortion, but they didn’t have to feel like the police were going to knock on their door,” she told me. “Now, if you’re able to find an abortion somewhere and you have a complication, do you get health care? Do you seek health care out if you’re having a miscarriage, or are you too scared? If you’re going to travel across state lines, can you tell your mother or your boss what you’re doing?”

In addition, she said that she was uncertain about the role that abortion funds —local, on-the-ground organizations that help people find, travel to, and pay for terminations—might play. “We really don’t know who is calling these hotlines,” she said. “When people call, what support do they need? What is enough, and who falls through the cracks?” She added that many people are unaware that such services exist, and might have trouble accessing them.

People are resourceful when seeking a termination and resilient when denied an abortion, Foster told me. But looking into the post- Roe future, she predicted, “There’s going to be some widespread and scary consequences just from the fact that we’ve made this common health-care practice against the law.” Foster, to her dismay, is about to have a lot more research to do.

About the Author

More Stories

The Truth About High Prices

Poor Black Kids Are Doing Better. Poor White Kids Are Doing Worse.

Find anything you save across the site in your account

The Study That Debunks Most Anti-Abortion Arguments

There is a kind of social experiment you might think of as a What if? study. It would start with people who are similar in certain basic demographic ways and who are standing at the same significant fork in the road. Researchers could not assign participants to take one path or another—that would be wildly unethical. But let’s say that some more or less arbitrary rule in the world did the assigning for them. In such circumstances, researchers could follow the resulting two groups of people over time, sliding-doors style, to see how their lives panned out differently. It would be like speculative fiction, only true, and with statistical significance.

A remarkable piece of research called the Turnaway Study, which began in 2007, is essentially that sort of experiment. Over three years, a team of researchers, led by a demographer named Diana Greene Foster, at the University of California, San Francisco, recruited 1,132 women from the waiting rooms of thirty abortion clinics in twenty-one states. Some of the women would go on to have abortions, but others would be turned away, because they had missed the fetal gestational limit set by the clinic. Foster and her colleagues decided to compare the women in the two groups—those who received the abortion they sought and those who were compelled to carry their unwanted pregnancy to term—on a variety of measures over time, interviewing them twice a year for up to five years.

The study is important, in part, because of its ingenious design. It included only women whose pregnancies were unwanted enough that they were actively seeking an abortion, which meant the researchers were not making the mistake that some previous studies of unplanned conceptions had—“lumping the happy surprises in with the total disasters,” as Foster puts it. In terms of age, race, income level, and health status, the two groups of women closely resembled each other, as well as abortion patients nationwide. (Foster refers to the study’s participants as women because, to her knowledge, there were no trans men or non-binary people among them.) Seventy per cent of the women who were denied abortions at the first clinic where they sought them carried the unwanted pregnancies to term. Others miscarried or were able to obtain late abortions elsewhere, and Foster and her colleagues followed the trajectories of those in the latter group as well.

While you might guess that those who were turned away had messier lives—after all, they were getting to the clinic later than the seemingly more proactive women who made the deadline—that did not turn out to be the case. Some of the women who got their abortions (half of the total participants) did so just under the wire; among the women in the study who were denied abortions (a quarter of the total), some had missed the limit by a matter of only a few days. (The remaining quarter terminated their pregnancies in the first trimester, which is when ninety per cent of abortions in the United States occur.) The women who were denied abortions were on average more likely to live below the poverty line than the women who managed to get them. (One of the main reasons that people seek abortions later in pregnancy is the need to raise money to pay for the procedure and for travel expenses.) But, in general, Foster writes, the two groups “were remarkably similar at the first interview. Their lives diverged thereafter in ways that were directly attributable to whether they received an abortion.”

Over the past several years, findings from the Turnaway Study have come out in scholarly journals and, on a few occasions, gotten splashy media coverage. Now Foster has published a patiently expository precis of all the findings in a new book, “ The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion .” The over-all impression it leaves is that abortion, far from harming most women, helps them in measurable ways. Moreover, when people assess what will happen in their lives if they have to carry an unwanted pregnancy to term, they are quite often proven right. That might seem like an obvious point, but much of contemporary anti-abortion legislation is predicated on the idea that competent adults can’t really know what’s at stake in deciding whether to bear a child or not. Instead, they must be subjected to waiting periods to think it over (as though they can’t be trusted to have done so already), presented with (often misleading) information about the supposed medical risks and emotional fallout of the procedure, and obliged to look at ultrasounds of the embryo or fetus. And such scans are often framed, with breathtaking disingenuousness, as a right extended to people—what the legal scholar Carol Sanger calls “the right to be persuaded against exercising the right you came in with.”

Maybe the first and most fundamental question for a study like this to consider is how women feel afterward about their decisions to have an abortion. In the Turnaway Study, over ninety-five per cent of the women who received an abortion and did an interview five years out said that it had been the right choice for them. It’s possible that the women who remained in the study that long were disproportionately inclined to see things that way—maybe if you were feeling shame or remorse about an abortion you’d be less up for talking about it every six months in a phone interview with a researcher. (Foster suggests that people experiencing regrets might actually be more inclined to participate, but, to me, the first scenario makes more psychological sense.) Still, ninety-five per cent is a striking figure. And it’s especially salient, again, in light of anti-choice arguments, which often stress the notion that many of the quarter to third of all American women who have an abortion will be wracked with guilt about their decision. (That’s an awful lot of abject contrition.) You can pick at the study for its retention rate—and some critics, particularly on the anti-abortion side, have. Nine hundred and fifty-six of the original thousand-plus women who were recruited did the first interview. Fifty-eight per cent of them did the final interview. But, as Foster pointed out in an e-mail to me, on average, the women in the study completed an impressive 8.4 of the eleven interviews, and some of the data in the study—death records and credit reports—cover all 1,132 women who were originally enrolled.

To the former Supreme Court Justice Anthony Kennedy, among others, it seemed “unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained.” In a 2007 abortion-case ruling, he wrote that “severe depression and loss of esteem can follow.” It can , but the epidemiologists, psychologists, statisticians, and other researchers who evaluated the Turnaway Study found it was not likely. “Some events do cause lifetime damage”—childhood abuse is one of them—“but abortion is not common among these,” Foster writes. In the short term, the women who were denied abortions had worse mental health—higher anxiety and lower self-esteem. In the longer run, the researchers found “no long-term differences between women who receive and women who are denied an abortion in depression, anxiety, PTSD, self-esteem, life satisfaction, drug abuse, or alcohol abuse.” Abortion didn’t weigh heavily in determining mental health one way or the other. Foster and her co-authors note, in an earlier article, that “relief remained the most commonly felt emotion” among women who got the abortions they sought. That relief persisted, but its intensity dissipated over time.

Other positive impacts were more lasting. Women in the study who received the abortion they sought were more likely to be in a relationship they described as “very good.” (After two years, the figure was forty-seven per cent, vs. twenty-eight per cent for the women turned away.) If they had been involved with a physically abusive man at the time of the unwanted pregnancy, they were less likely to still be experiencing violence, for the simple reason that they were less likely to be in contact with him. (Several of the participants interviewed for the book talk about not wanting to be tethered to a terrible partner by having a child together.) Women who got the abortion were more likely to become pregnant intentionally in the next five years than women who did not. They were less likely to be on public assistance and to report that they did not have enough money to pay for food, housing, and transportation. When they had children at home already, those children were less likely to be living in poverty. Based on self-reports, their physical health was somewhat better. Two of the women in the study who were denied abortions died from childbirth-related complications; none of the women who received abortions died as a result. That is in keeping with other data attesting to the general safety of abortion. One of Foster’s colleagues, Ushma Upadhyay, analyzed complications after abortions in California’s state Medicaid program, for example, and found that they occurred in two per cent of the cases—a lower percentage than for wisdom-tooth extraction (seven per cent) and certainly for childbirth (twenty-nine per cent). Indeed, maternal mortality has been rising in the U.S.—it’s now more than twice as high as it was in 1987, and has risen even more steeply for Black women, due, in part, to racial disparities in prenatal care and the quality of hospitals where women deliver.

Yet, as Foster points out, many of the new state laws restricting abortion suggest that it is a uniquely dangerous procedure, one for which layers of regulation must be concocted, allegedly to protect women. The Louisiana law that the Supreme Court struck down last Monday imposed just such a rule—namely, a requirement that doctors performing abortions hold admitting privileges at a hospital no more than thirty miles away. As Justice Stephen Breyer’s majority opinion noted, “The evidence shows, among other things, that the fact that hospital admissions for abortion are vanishingly rare means that, unless they also maintain active OB/GYN practices, abortion providers in Louisiana are unlikely to have any recent in-hospital experience.” Since hospitals often require such experience in order to issue admitting privileges, abortion providers would be caught in a Catch-22, unable to obtain the privileges because, on actual medical grounds, they didn’t need them. The result of such a law, had it gone into effect, would have been exactly what was intended: a drastic reduction in the number of doctors legally offering abortions in the state.

The Turnaway Study’s findings are welcome ones for anyone who supports reproductive justice. But they shouldn’t be necessary for it. The overwhelming majority of women who received abortions and stayed in the study for the full five years did not regret their decision. But the vast majority of women who’d been denied abortions reported that they no longer wished that they’d been able to end the pregnancy, after an actual child of four or five was in the world. And that’s good, too—you’d hope they would love that child wholeheartedly, and you’d root for their resilience and happiness.

None of that changes the fundamental principle of human autonomy: people have to be able to make their own decisions in matters that profoundly and intimately affect their own bodies and the course of their lives. Regret and ambivalence, the ways that one decision necessarily precludes others, are inextricable facts of life, and they are also fluid and personal. Guessing the extent to which individuals may feel such emotions, hypothetically, in the future, is not a basis for legislative bans and restrictions.

The Turnaway Study will be understood, criticized, and used politically, however carefully conceived and painstakingly executed the research was. Given that inevitability, it’s worth underlining the most helpful political work that the study does. In light of its findings, the rationale for so many recent abortion restrictions—namely, that abortion is uniquely harmful to the people who choose it—simply topples.

Why Abortion is Seriously Wrong: Two Views

• First Online: 22 October 2010

Cite this chapter

• Donald Marquis 2  

Part of the book series: Philosophy and Medicine ((volume 110))

933 Accesses

2 Citations

The purpose of this essay is to compare the substantial identity argument for the wrongness of abortion to the future of value argument for its wrongness. Both arguments take for granted the standard moral judgment that it is wrong intentionally to end the lives of innocent post-natal children and adults.

This essay was begun while I was Laurance S. Rockefeller Visiting Professor for Distinguished Teaching at Princeton University and was motivated by discussions with Robert George and Patrick Lee while I was there. I am deeply indebted to Princeton University for the opportunity provided by that appointment and to Pat and Robby for prodding me intellectually.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

Baruch Brody and the principle of justifiable homicide

Childbearing, abortion and regret: a response to kate greasley.

Some Critical Reflections on Abortion and Virtue Theory

Beckwith, F.P. 2007. Defending life: A moral and legal case against abortion choice . Cambridge, MA: Cambridge University Press.

Google Scholar  

Boyle, J.M. 1979. That the fetus should be considered a legal person. The American Journal of Jurisprudence 59:59–71.

Boyle, J.M. 1989. Sanctity of life and suicide: Tensions and developments within common morality. In Suicide and euthanasia , ed. B. Brody, 221–250. Dordrecht, The Netherlands: Kluwer.

Boyle, J.M. 2008. Towards ethical guidelines for the use of artificial nutrition and hydration. In Artificial nutrition and hydration: The new Catholic debate , ed. C. Tollefsen, 111–121. Dordrecht, The Netherlands: Springer.

Brown, M. 2000. The morality of abortion and the deprivation of futures. The Journal of Medical Ethics 26:103–107.

Article   Google Scholar  

DeGrazia, D. 2005. Human identity and bioethics . New York, NY: Cambridge University Press.

Book   Google Scholar  

Dworkin, R. 1993. Life’s Dominion: An argument about abortion, euthanasia, and individual freedom. New York, NY: Alfred A. Knopf.

Harris, J. 1999. The concept of the person and the value of life. Journal of the Kennedy Institute of Ethics 9:293–308.

Lee, P. 2004. The pro-life argument from substantial identity: A defense. Bioethics 18:249–263.

Lee, P., and R.P. George. 2008. Body-self dualism in contemporary ethics and politics . Cambridge, MA: Cambridge University Press.

Marquis, D. 1989. Why abortion is immoral. The Journal of Philosophy 86:138–202.

McMahan, J. 2002. The ethics of killing: Problems at the margins of life . Oxford: Oxford University Press.

Rachels, J. 1986. The end of life . Oxford: Oxford University Press.

Reiman, J. 1999. Abortion and the way we value human life. Lanham, MD: Rowman and Littlefield.

Shewmon, D.A. 2001. The brain and somatic integration: Insights into the standard biological rationale for equating ‘Brain Death’ with death. Journal of Medicine and Philosophy 26:457–478.

Singer, P. 1979. Practical ethics. Cambridge, MA: Cambridge University Press.

Steinbock, B. 1992. Life before birth . New York, NY: Oxford University Press.

Stretton, D. 2004. Essential properties and the right to life: A response to lee. Bioethics 18:254–281.

Tooley, M. 1972. Abortion and infanticide. Philosophy and Public Affairs 2:37–65.

Download references

Author information

Authors and affiliations.

University of Kansas, Lawrence, KS, USA

Donald Marquis

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Donald Marquis .

Editor information

Editors and affiliations.

, Dept of Philosophy, University of South Carolina, Columbia, 29208, South Carolina, USA

Christopher Tollefsen

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media B.V.

About this chapter

Marquis, D. (2011). Why Abortion is Seriously Wrong: Two Views. In: Tollefsen, C. (eds) Bioethics with Liberty and Justice. Philosophy and Medicine(), vol 110. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-9791-0_1

Download citation

DOI : https://doi.org/10.1007/978-90-481-9791-0_1

Published : 22 October 2010

Publisher Name : Springer, Dordrecht

Print ISBN : 978-90-481-9790-3

Online ISBN : 978-90-481-9791-0

eBook Packages : Humanities, Social Sciences and Law Philosophy and Religion (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

• Search Menu
• Sign in through your institution
• Advance articles
• Author Guidelines
• Open Access
• Why Publish with JMP?
• About The Journal of Medicine and Philosophy
• Editorial Board
• Advertising and Corporate Services
• Journals Career Network
• Self-Archiving Policy
• Dispatch Dates
• Terms and Conditions
• Journals on Oxford Academic
• Books on Oxford Academic

Article Contents

I. introduction, ii. how many induced abortions and miscarriages are there, iii. causes of miscarriage, iv. other reasons for prioritizing anti-abortion advocacy, v. the central argument, vi. is the deprivation account true, vii. is there an alternative account of the wrongness of killing, viii. differing norms for killing and letting die, ix. implications.

• < Previous

The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage

• Article contents
• Figures & tables
• Supplementary Data

Calum Miller, The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine , Volume 48, Issue 3, June 2023, Pages 225–242, https://doi.org/10.1093/jmp/jhad014

• Permissions Icon Permissions

Several recent papers have suggested that the pro-life view entails a radical, implausible thesis: that miscarriage is the biggest public health crisis in the history of our species and requires radical diversion of funds to combat. In this paper, I clarify the extent of the problem, showing that the number of miscarriages about which we can do anything morally significant is plausibly much lower than previously thought, then describing some of the work already being done on this topic. I then briefly survey a range of reasons why abortion might be thought more serious and more worthy of prevention than miscarriage. Finally, I lay out my central argument: that reflection on the wrongness of killing reveals that the norms for ending life and failing to save life are different, in such a way that could justify the prioritization of anti-abortion advocacy over anti-miscarriage efforts. Such an account can also respond to similar problems posed to the pro-lifer, such as the question of whom to save in a “burning lab” type scenario.

In recent years, pro-lifers have been criticized for focusing disproportionately on the issue of abortion, while at the same time neglecting the apparently much greater number of deaths from spontaneous abortion ( Ord, 2008 ; Berg, 2017 ; Simkulet, 2017 ). A similar problem is suggested by the scenario which asks us to consider whether we would save multiple embryos or a single child in a burning laboratory—the intuition commonly being that we should save the single child. 1 Different implications might be drawn from this, including that pro-lifers do not really believe that embryos are human beings with a right to life, 2 or that pro-lifers are more interested in limiting women’s autonomy, or both. In this paper, I marshal a series of arguments to explain why these conclusions are unwarranted. In particular, I suggest that reflection on the wrongness of killing shows that it is largely unrelated to consequences, and even largely unrelated to the badness of death. This furnishes the pro-lifer with a reason to seek the prevention of abortion more urgently than the prevention of miscarriage, and indeed for pro-lifers to preferentially rescue older children over embryos. But, it also supplies a more general reason to think that the distinction between killing and letting die is relevant, and for thinking that the norms shaping behavior in those situations differ.

It is worth briefly reviewing the evidence regarding induced abortion and miscarriage. This does not make a great difference to my central argument, but most authors have noted that even if there are clear reasons to prioritize tackling a lesser number of abortions over a greater number of miscarriages, there is some residual (indeed, substantial) reason for pro-lifers to address those miscarriages which do occur, which undoubtedly number many millions. Let me say something about this.

Estimates for the number of miscarriages vary, although it appears likely that most are exaggerated. Berg suggests up to 89% of all pregnancies, while Ord suggests that there are 226 million worldwide every year. These are almost certainly vast overestimates. In a recent comprehensive review, Jarvis (2017) proposes somewhere between 40% and 60% of all pregnancies end in miscarriage, noting that higher figures are implausibly excessive. Around 10%–35% of embryos are lost before implantation, a further 10%–20% before clinical recognition of pregnancy, and 5%–15% between clinical recognition and birth. We note in particular the large range for embryo loss before implantation: the relevant events are extremely difficult to measure, and so we have very low confidence in our estimates.

Globally, there are around 140 million births a year ( Our World in Data, 2020 ). If around half of the pregnancies are ended prematurely (the midpoint of 40%–60%), then there are around 140 million spontaneous abortions a year. This is obviously a very large number—far exceeding the number of induced abortions, even. That said, it is still 80 million or so less than Ord’s estimate.

This does not, of course, take into account induced abortions. Some pregnancies end neither in birth nor spontaneous abortion, and this will affect the estimate of spontaneous abortions (if there are more total pregnancies, then there are likely more spontaneous abortions, although some of these will result in induced abortions before a miscarriage occurs). This does not affect the estimate by a very great deal, relatively speaking. Very likely, the number is somewhere between 100 and 200 million, which is enough for the argument to get going. Ord and Berg have likely overestimated it by quite some way, however, which reduces considerably the ostensible disproportion with which they allege pro-lifers to act.

Blackshaw and Rodger (2019) note that about a third of spontaneous abortions are anembryonic pregnancies, where the embryo proper does not actually form (or forms briefly, and then disappears). If the embryo never forms, then according to the standard pro-life view, there is no organism and hence, no life is lost. This would reduce the salience of spontaneous abortion for pro-lifers. However, the events in early pregnancy are too poorly understood (at least in frequency) to know how many anembryonic pregnancies involve embryos that formed and then were destroyed, which would presumably still count as deaths. Although there are other “pregnancies” where a human being likely does not form, 3 I shall ignore these and take the estimate of 140 million lives lost as broadly correct—my argument is precisely intended to explain how pro-lifers are justified in paying more attention to a more limited number of lives.

Although Ord and Berg overestimate the number of miscarriages, the number of abortions is also likely to be substantially lower than some of their pro-life respondents (and authorities such as the WHO) have suggested. Blackshaw and Rodger cite a study from the Guttmacher Institute which estimates around 56 million abortions a year. ( Sedgh et al., 2016 ) Although details of the data used in the Guttmacher study are sparse, it seems reasonable to believe they have relied at least in part on previous Guttmacher studies that overestimate the number of illegal abortions by an order of magnitude in many countries. For example, Koch, Bravo et al. (2012) have provided powerful arguments that the Guttmacher Institute overestimates the number of abortions in Colombia by around 10-fold. In Mexico, a Guttmacher study estimated 137–194,000 abortions per annum for Mexico’s Federal District. After abortion was legalized in this region (the only region in the country), however, the subsequent 5 years yielded only 78,544 abortions across the entire period ( Koch, Aracena et al., 2012 ). 4 Given how prone to radical overestimates abortion statistics are, 56 million may be a large overestimate—although there are certainly many millions every year. 5 Probably, the total number of spontaneous abortions still exceeds the number of induced abortions by several times. For Colgrove (2021) and Blackshaw and Rodger (2019) , this does affect the argument, although not by a great deal and likewise for my own argument.

As Colgrove describes at length, “spontaneous abortion” or “miscarriage” (used interchangeably here) is not a cause of death in itself: it is just the phenomenon of natural deaths in utero (prior to viability, after which point the terminology used is “stillbirth”). So, saying that spontaneous abortion is responsible for more deaths than induced abortion is like saying that natural death is responsible for more deaths than homicide or genocide. This is evidently not a very persuasive argument for not paying significant attention to homicide and genocide, nor is it very informative about the causes of death.

Spontaneous abortion is made up of a variety of different causes, as helpfully summarized by Blackshaw and Rodger. They note that around 60% are due to aneuploidies, where an embryo has an anomalous number of chromosomes in each cell (as in Down Syndrome). 6 We can also add to these euploid genetic causes ( Colley et al., 2019 ), and hence, the number of miscarriages due to genetic causes is greater—though we are unsure by how much—than simply the proportion due to aneuploidies. Other causes include immunological conditions, thrombophilias, endocrinological causes, uterine malformations, and acute maternal infections. Certain lifestyle factors (e.g., smoking), chronic conditions (e.g., diabetes), and non-modifiable risk factors (e.g., increasing age) also appear to contribute.

Blackshaw and Rodger use this analysis to argue that induced abortion is actually one of the largest causes of prenatal death: on their analysis, 44% are due to aneuploidies, 27% due to induced abortion, and 29% due to other causes. 7 They note, further, that treating aneuploidies is very difficult since we have no treatment and, since they usually occur before detection of pregnancy, prevention is likewise difficult. Ord rightly objects that this does not rule out research. For example, Alzheimer’s is largely unpreventable, and so we invest instead primarily in research. Ord also suggests sperm sorting to prevent the anomalies in the first place. Blackshaw and Rodger respond to the suggestion of research by noting that most such research is likely to be ethically problematic if, for example, it involves research on embryos. But, in Ord’s defence, it is not entirely clear that this is the case: aneuploidy and spontaneous abortion both occur in animals, and animal models may shed considerable light on the causes and possible prevention. Blackshaw and Rodger note also that keeping human beings with fatal chromosomal defects alive for an inevitably short period is not necessarily an overriding moral obligation: this is true, but if those fatal chromosomal defects are themselves remediable in principle, then this response will not work, since we would have at least some obligation (even if not overriding) to extend their lives.

There is a bit more we can say about the relevance of chromosomal anomalies, however. First, the aneuploidies are themselves quite varied: Hassold et al. (1980) report that about a quarter are due to Turner Syndrome (only one sex chromosome, X), nearly half due to trisomies (such as Down, Patau, and Edwards Syndrome), and nearly a quarter triploidy and tetraploidy (one or two extra copies of each chromosome), inter alia.

Here is one pro-life response: just as “miscarriage” is an artificially large group, so too is “aneuploidy”: it groups together a wide range of conditions (from Down Syndrome to Turner Syndrome, to tetraploidy), which do not really constitute a single cause of death. The largest cause of death is Turner Syndrome, responsible for, we suppose, 15% of spontaneous abortions, so perhaps 20,000,000 lives lost a year. This may be equal to, or even fewer than, the number of induced abortions (certainly considerably less according to the Guttmacher and WHO estimates). 8

That the causes may be split up into specific conditions may not affect the argument significantly. After all, if we suppose that resources should be apportioned relative to the burden of mortality, Ord and Berg still have an argument that the total expenditure on chromosomal anomalies ought to exceed spending on induced abortion when added altogether, and clearly pro-lifers do not expend as many resources on chromosomal anomalies as on induced abortion. That said, there being a wider variety of conditions may affect the efficiency of the research and hence, could justify more spending on abortion: if miscarriages had 140,000,000 different causes, it is plausible that the cost to find a treatment for 50,000,000 spontaneous abortions is likely to be higher than the cost of preventing 50,000,000 induced abortions. So, a significant amount may depend on the extent to which the disparate causes of spontaneous abortion are likely to have treatments derived through similar or the same research. Berg and Ord may have a point that pro-lifers, on the whole, have not even attempted this calculation (difficult though it surely is): they may be right that the pro-life community as a whole has a moderate duty to at least attempt a calculation of this sort before deciding that preventing abortion is most cost-efficient.

However, there is a much more powerful reason why the proportion of deaths caused by genetic anomalies (chromosomal or otherwise) and the careful distinction of these genetic anomalies may be important. The reason is that some genetic anomalies—especially those in question here—may be so radical as to prevent the creation of a human organism or, more plausibly, that changes to certain genetic constitutions may not be identity preserving.

We clearly do not want to say that any chromosomal anomaly prevents the entity constituting an organism. People with Turner Syndrome and Down Syndrome are clearly human beings and moral equals. 9 What about those with tetraploidy? That seems less clear. I suspect we do not know enough about genetics at this point to be able to judge whether most entities with extreme chromosomal anomalies are human organisms. 10 My own view is that most or all are. In any case, perhaps even uncertainty should make us err on the side of caution, granting them personhood unless we have clear evidence that they are not organisms. So, this response will not do a great deal.

What seems much more plausible is that large changes in genetic constitution may not be identity-preserving. I have previously defended this view ( Miller and Pruss, 2017 ), noting that even some relatively small genetic changes (such as in Tay–Sachs disease, which can be caused by mutation of a single base pair) may not be identity-preserving. Would I be the same person if I had Tay–Sachs or Turner Syndrome? Or if I had the opposite assortment of sex chromosomes? It is very plausible that I would not be. If so, then it seems like most aneuploidies—and hence, a very large proportion of spontaneous abortions—result in a different human being to the human being they would have formed if the anomaly had not occurred.

If substantial genetic changes are not identity-preserving, then many genetic anomalies are not treatable. This is not for technical inability—which could be solved with enough research—but because it is metaphysically impossible to treat the genetic anomaly without altering the identity of the individual. Hence, these deaths are unpreventable in a way that cannot be solved by research, and so it is difficult to see how any resources could be devoted to them.

On a certain view—which I suspect most pro-lifers would endorse—this matters a great deal. On this view, it is not necessarily wrong—and certainly not comparable to murder—to bring into existence a genetically anomalous child, even if one could have acted differently and brought into existence a healthy child. 11 Indeed, intuitively, the main reason why it might be wrong to bring into existence a severely disabled child is the suffering that the child would bear. This reason is nullified in the case of a child who will not suffer because they die before their nervous system is sufficiently developed, or if the particular kind of suffering would only occur at a later point after the spontaneous abortion (e.g., from hypoxia due to inadequate ventilation). In short, it is not comparable to murder to bring into existence a child with, say, trisomy 2, who will die before birth.

This is important because Ord and others suggest that these deaths are preventable by preventing that particular conception, with that genetic constitution, from occurring. But, preventing a person from ever existing is hardly morally equivalent to saving their life, even though both are spared death (in different senses). A person with trisomy 2 is not benefitted by being prevented from ever existing in the first place. Conversely, they are not harmed by being brought into existence for a very short time. Thus, it makes no sense to say that these are preventable deaths, or to say that pro-lifers have a duty to prevent these conceptions taking place. They are preventable deaths only in the sense that they stop someone from ever existing in the first place: by that measure, every death is preventable. Clearly, this is implausible and should not have a significant impact on policy—preventing deaths in the sense of preventing people with a short life expectancy from existing is simply not a duty, certainly not a duty comparable to preventing homicides. At the very least, we can say that bringing into existence persons who will die shortly after their conception, and thereby in some sense causing those persons’ death, is obviously not equivalent to murder. Arguably, it is not wrong at all. Hence, there is no argument for thinking that pro-lifers should seek to prevent these deaths over the deaths caused by induced abortion. 12

I said earlier that the distinction of specific genetic anomalies may be important for this response. Some genetic changes are plausibly identity-preserving, while others are not, and so pro-lifers may have some reason to research gene therapy for some individuals as a way to save lives. But, that number of individuals will probably be a much smaller number than the number of lives lost to aneuploidy. It is certainly plausible that many aneuploid individuals are literally untreatable—treating them is not even metaphysically possible. And so the number of preventable miscarriages is plausibly much lower than 140 million.

If I am right that the number of induced abortions is vastly lower than 56 million, these points will still not suffice. For, even if we exclude all those cases of “essential” aneuploidy (and other genetic anomalies which are literally untreatable), the number of spontaneous abortions with preventable causes may well still exceed the number of induced abortions, and so still generate a potential inconsistency for the pro-lifer.

Still, everyone in the debate is agreed that pro-lifers should ensure that something is being done to save lives lost in miscarriages. We should also agree that the loss of life due to miscarriage is seriously regrettable—this is far from unintuitive, however. Indeed, it is difficult to give an account of the badness of death that does not have the implication that spontaneous abortion is a very bad thing, not to mention the grief women suffer from miscarriage—enough for the UK’s leading abortion provider to refer to it as “The inconceivable grief of baby loss” ( British Pregnancy Advisory Service, 2020 ).

As it turns out, much is already being done to try and prevent miscarriages: a great deal of research, involving many millions of pounds, is already being done on the causes of miscarriage. Even in 2005, over $2.9 billion was spent globally on genetics research ( Pohlhaus and Cook-Deegan, 2008 ), while the fertility business makes an estimated $25 billion a year in sales, much of which presumably goes into research on helping pregnancies come to term ( The Economist, 2019 ). Sometimes this research is carried out specifically by pro-life or Catholic organizations (see NaProTechnology, 2020 ). It goes without saying that there is already enormous global expenditure on public health campaigns trying to stop smoking, on research on chronic conditions contributing to miscarriage like diabetes, and so on. Even recurrent miscarriage is the subject of a great deal of research. There is no large research budget for “miscarriage” generally because it has a wide variety of causes. But, for those individual causes, there are enormous research budgets. While a quantitative analysis is beyond the scope of this paper, it seems plausible that money spent on research helping to prevent miscarriages vastly exceeds money spent on preventing abortion, even when controlling for the numbers of miscarriages and abortions. 13 If so, it is hardly clear what pro-lifers are expected to do. We do not expect researchers in non-malignant thyroid disease to spend any time, let alone a large majority of it, on researching cancer, despite the far greater mortality of the latter. Why? Because other people are already doing it, disproportionately, even. Likewise, given the relatively meager budgets of pro-life organizations, it is hard to see why they should spend it on miscarriage research, given the vastly greater sums of money already being spent on such research. 14

Before turning to the argument that I wish to develop in detail, it is worth briefly summarizing just a few reasons (in addition to the considerations above) why pro-lifers might reasonably consider abortion to be more worth preventing than miscarriage. These will be of relevance to my central argument, as we shall see. We begin with a series of reasons why abortion is more degrading than miscarriage:

1) Methods of abortion are often degrading. In England and Wales, for example, around 10,000 abortions every year involve dismembering the live fetus, a fetus at around 14 weeks’ gestation or more ( Department of Health and Social Care, 2020 ). In some other countries, surgical abortions (of which those at later gestations involve dismemberment) are more common still ( Guttmacher Institute, 2019 ; Popinchalk and Sedgh, 2019 ). Public opinion in the U.S. shifted significantly toward the pro-life position in the mid-1990s ( Gallup, 2020 ) around the time partial-birth abortion began to be publicized, eventually leading to a federal prohibition. Partial birth abortion was normally performed on healthy babies in healthy mothers ( New York Times, 1997 ) and involved delivering a living child all except for the head, at which point “blunt scissors” are forced into the baby’s skull so that the “skull contents” (i.e., the brain) can be suctioned out ( Haskell, 1992 ). One nurse testified:

Dr. Haskell went in with forceps and grabbed the baby’s legs and pulled them down into the birth canal. Then he delivered the baby’s body and the arms—everything but the head. The doctor kept the head right inside the uterus … The baby’s little fingers were clasping and unclasping, and his little feet were kicking. Then the doctor stuck the scissors in the back of his head, and the baby’s arms jerked out, like a startle reaction, like a flinch, like a baby does when he thinks he is going to fall. The doctor opened up the scissors, stuck a high-powered suction tube into the opening, and sucked the baby’s brains out. Now the baby went completely limp … He cut the umbilical cord and delivered the placenta. He threw the baby in a pan, along with the placenta and the instruments he had just used. ( Supreme Court of the United States, Gonzales v. Carhart , 550 U.S. 124 (2007) , 8)

In my experience, those hearing this description have described it as straightforward murder, if not a crime against humanity, regardless of their general position on abortion. In any case, it is not difficult to see why someone would regard this, other things being equal, as worse than a miscarriage, even than a stillbirth of the same gestation. It is worth noting that recent research suggests fetal pain from 12 weeks is distinctly possible—and certainly at later stages ( Derbyshire and Bockmann, 2020 ).

A ban on this procedure was vetoed by President Clinton, opposed by the majority of House and Senate Democrats, and even declared unconstitutional by four Supreme Court judges. 15 Although partial birth abortions constituted only a small proportion of abortions, it was responsible for an estimated 3,000–5,000 abortions a year, 500–750 of which were after 7 months’ gestation ( Johnston, 2007 ). By contrast, Presidential candidate Elizabeth Warren (2019) described children dying by gun violence in the US as a “national health emergency,” responsible for around the same number of deaths ( Cunningham et al., 2018 ). Partial birth abortions alone counted only for a very small proportion of surgical abortions in the US. This is relevant because a major political party in the most powerful country in the world supporting this kind of degradation—while claiming that the same number of deaths from another cause is a “national health emergency”—adds a further level of systemic institutional degradation against human beings in the womb.

2) Abortion, on the pro-life view, involves a violent attack within the family—hence, many early Christian writers referred to it as “parricide.” As well as parricide being particularly destructive within a family, widespread parricide plausibly results in a more general destruction of the family by the normalization of the dispensability of children and the erosion of the appreciation for motherhood. Since, according to the Universal Declaration of Human Rights Article 16, the family is the “natural and fundamental group unit of society and is entitled to protection by society and the State,” 16 the widespread breakdown of the family is plausibly a unique and serious evil to be prevented at any cost, in contrast to miscarriage which—while causing families much grief—does not involve the same kind of relational fracturing. Relatedly, abortion contributes to a widespread culture of the dispensability of children, which plausibly contributes in the same way to more general societal harms. Along similar lines, pro-lifers often think that abortion contributes to a sexual culture that is likewise destructive to human flourishing (and disproportionately so for women and the poor) by severing the link between sex and procreation ( Alvaré, 2011 ).

3) Abortion involves the systematic and state-sponsored violence against a particular class of people, which most of us would regard as worse than the natural death of the same number of people. One reason we are appalled at the Holocaust, the Rwandan genocide, the Armenian genocide, and so on, is because of the systematic and state-sponsored violence specifically impacting (and even targeted toward) a vulnerable demographic group on a large scale. There are multiple elements here, all of which no doubt contribute to the horror of these genocides, and all of which seem on initial inspection to justify greater attention than the equivalent number of deaths by natural causes. Even on much smaller scales, many of us think that it is reasonable to take radical action over violence against vulnerable groups, exceeding our response to natural deaths among those groups. Perhaps the most salient example is from the Black Lives Matter movement. The Guardian reports that in 2016, 39 unarmed black men were killed by US police. Compared to other causes of death, this is a relatively small number. Yet, we rightly realize that it is much more salient than 39 deaths from natural causes, justifying a much more significant public response. As Colgrove puts it, “BLM has a particular target. It is not solely fixated on saving as many lives as possible. It is aimed at revealing (and undoing) systematic injustice that is directed toward certain people” ( Colgrove, 2021 ).

4) Abortion involves the systematic dehumanization of a class of people. One of the most basic rights of human beings is to be recognized as a person, 17 and it seems clear that the dehumanization of certain classes of people (whether Jews, black slaves, Tutsis, disabled people, or others) is a serious aggravating factor to many crimes, especially genocides. This raises a particularly salient point: as well as dehumanization being an aggravating element of mass killing, working to oppose dehumanization constitutes the bulk of pro-life work in many countries. It may even be that humanizing the fetus is the best way to garner public support for putting resources into preventing miscarriage, and that discussion of abortion is one of the best ways to demonstrate the humanity of the fetus (the Partial Birth Abortion Ban Act and its effect on public opinion suggest this may be the case). 18

5) In the case of abortion, tens to hundreds of millions of dollars are spent advocating for abortion all over the world as a basic human right and as a part of essential health care. There is not a similar movement promoting miscarriage. This means that the dehumanization involved in abortion is not only ideological: it is institutionalized in our economic system, with hundreds of millions of dollars invested into its propagation. 19

6) In the case of abortion, the killing and dehumanization receive the imprimatur of the state and the law (and institutions like the UN and the WHO, insofar as they are able to make pronouncements not reflecting international consensus). The expressive function of the law is powerful—we can see this by asking whether we would allow, for example, the state to declare that African Americans are not fully human, if for some reason it meant that they received better treatment. 20 People are divided on this question—which is enough, I think, to show that the expressive function of the law plausibly might outweigh a certain number of lost lives. It is one degradation to have a large number of the population dehumanize you: it is another level of degradation to have this enshrined in law, and in the major political institutions. Thus, the ideological and economic weight behind abortion is compounded by political weight; it is plausibly more degrading—and certainly more of a problem—for the dehumanization of a class of human beings to have the imprimatur of the ruling institutions. 21

7) If, as many prominent philosophers have thought, virtue is a constituent of well-being, then on the pro-life view abortion is also extremely harmful to those participating in abortion. More generally, if you think that our character is more important than our experiences, you would have a strong interest in preventing abortion that does not apply to miscarriage. There is also evidence linking abortion with increased suicide rates and increased mortality ( Fergusson et al., 2013 ; Karalis et al., 2017 ), suggesting more lives may be lost due to abortion (though of course, not enough to match those lost in miscarriage). While this does not necessarily make abortion more degrading for the primary victim, it is another reason to oppose more strongly than miscarriage. 22

8) One of the primary obstacles to generating substantial societal support for miscarriage and abortion prevention is the view that unborn human beings are not really human, or are not equally morally considerable. (Effective) anti-abortion advocacy helps to remove this obstacle for both causes, and perhaps more effectively than miscarriage prevention advocacy.

As a sense of what is at work here, imagine tens or hundreds of thousands of members of another vulnerable group were dismembered alive each year, with the social, legislative, and financial support of the most powerful governments around the world, as well as immensely powerful NGOs, the UN, and the WHO. Imagine this was just the tip of the iceberg for many millions more who were killed in less graphically violent ways. Now imagine there was already a great deal of research being put into saving these people from dying due to natural causes. It seems overwhelmingly likely to me that we would think we had a mandate to invest significantly more resources to stop the state-sponsored killing, compared to preventing the equivalent number of people dying from natural causes. We certainly could not rightly criticize human rights groups for paying significantly more attention to the former. The same situation is broadly what we have in the case of abortion, from the pro-life viewpoint. Indeed, comparisons to mass killings such as the Holocaust are perhaps the best way to understand the pro-life mindset for our purposes here , since such comparisons are the intuitive reason many pro-lifers offer for making abortion a central political and social priority.

I make no claims here about exactly to what extent the large numbers involved contribute to the horror of mass killings and systemic dehumanization. It might be that what made other mass killings so abhorrent is the large numbers. If so, then this only serves to make abortion more serious. In the case of abortion, we appear to have both factors: systemic violence and degradation, as well as enormous numbers.

Since my central argument is to do with the respect owed to victims of killing, all of the considerations here which pertain to the degradation and dehumanization involved in abortion will amplify the force of that argument, to which we now turn.

The suggestion that killing and letting die are morally inequivalent is hardly a new one, nor is its application in this context. Indeed, it is the obvious response to the argument: it is the most obvious difference between induced abortion and miscarriage. But perhaps it is undermotivated or ad hoc. Why think that they are morally distinct? Indeed, some philosophers have suggested that they are not distinct when all other things are equal ( Simkulet, 2019 ). Here, I propose an argument for thinking that they are distinct, and that this has significant implications for prioritizing the prevention of killing vis-à-vis the prevention of natural deaths.

My starting point is with the badness of death and the wrongness of killing. In the context of abortion, this has been heavily influenced by Marquis’ (1989) seminal work arguing that abortion (and killing more generally) are wrong because they deprive someone of a future life of value. This is a kind of deprivationist account of the wrongness of killing, and for many people it is an intuitive account of the wrongness of killing. Marquis’ paper is no doubt popular because it was one of the first major papers to be published for the pro-life position in the recent renaissance of pro-life philosophy. It is also an extremely simple and intuitive argument. As it happens, I think that the paper is largely correct, accounting for one reason why abortion is wrong. Marquis’ work deserves the attention it has received, including in recent discussions. 23

Now I do not, in fact, think that it is the central reason for the wrongness of abortion. To help explain my position, consider another feature of Marquis’ argument: it implies that the wrongness of killing is closely tied to the badness of death, which is widely variable. As Blackshaw and Rodger (2019) note, the badness of death differs a large amount between persons. But, if killing is wrong primarily because it deprives someone of a future life of value, then the wrongness of killing can vary from extremely wrong (in the case of embryos) to minimally, or perhaps not wrong at all (in the case of people killed near the end of their lives, or in the case of severely disabled people who are not able to enjoy much). The precise results in these cases depend on what is considered “valuable” about life, but it seems as though defenders of Marquis tend primarily to emphasize valuable experiences, rather than the inherent value of life itself.

It has been claimed that this kind of deprivationism is the standard view among pro-lifers. Indeed, Simkulet criticizes Friberg-Fernros’ defence of the significance of the distinction between killing and letting die by saying that “this view is at odds with the commonsense antiabortion position, grounding the wrongness of induced abortion not in the death of the fetus, but in the act of killing (or in disconnect cases, letting die)” ( Simkulet, 2019 ).

In fact, however, there are many reasons to think that the orthodox pro-life position is not based solely (or even primarily) on the badness of death. I would go further: it is actually intrinsic to the pro-life account that the wrongness of killing is not correlated with the badness of death. For example, pro-lifers are typically just as fiercely opposed to euthanasia or assisted suicide—even if the patient has almost no life of value remaining—as they are to abortion, which prevents many decades of valuable life. If killing is wrong because it deprives the victim of a future life of value, abortion should be considered orders of magnitude (if someone is killed by involuntary euthanasia a day before they were likely to die anyway, then abortion would be roughly 365 × 70 = roughly 25,000 times worse, or more if the euthanasia recipient is looking forward only to a day of misery) more wrong than euthanasia. But, pro-lifers tend to consider them roughly commensurate—or, at the very least, not as though one is 25,000 times more serious than the other. Pro-lifers object vehemently to the killing of people who are not likely to enjoy significant subjective goods in the future—for example, anencephalic children in the case of abortion, 24 or severely disabled or very elderly/terminally ill people in the case of euthanasia. The enormous effort to prevent the killing 25 of Terri Schiavo and the more recent case of Vincent Lambert are a testament to the seriousness with which pro-lifers take killing even in such cases. This is strong evidence that pro-lifers are not primarily pro-life because of potential future subjective goods to be experienced by the victim.

Second, the “traditional” pro-life approach was to speak of the “sanctity” of life. This terminology fits very well with the sense of intrinsic value and respect in the account I describe, and not so well with the view that life is valuable because of the subjective goods that may be experienced. Third, it is a staple of the pro-life view that life is intrinsically valuable—this is at odds with a view that takes life to be valuable primarily because of experienced goods. Pro-lifers make an extremely large point of valuing all human life, including where the quality of life may be very low. Pro-lifers consistently focus on the value of those with severe disabilities, which is surprising if they think the value of life is primarily determined by experienced goods. Fourth, many pro-lifers are pro-life for religious reasons, and religious prohibitions on killing have rarely, if ever, spoken of future goods. On the contrary, the Christian tradition, at least, has expressly used terminology more suitable to the respect theory I describe. This is perhaps best exemplified by Lactantius’ comments on killing at the turn of the fourth century: “Therefore, with regard to this precept of God, there ought to be no exception at all; but that it is always unlawful to put to death a man, whom God willed to be a sacred animal” ( Divine Institutes, 6.20 ). Finally, as Friberg-Fernros (2019) points out, the intention is extremely important for the pro-life view, which is why pro-lifers allow the foreseen death of fetuses to save the mother’s life, without ever allowing the intended death of fetuses.

Pro-lifers probably come across as being deprivationists primarily because many of them hold that deprivation is an additional reason why abortion is wrong, and—within philosophy—because of the influence of Marquis’ article on the debate in recent decades. But, that is no reason to suppose that the majority of pro-lifers only or primarily rely on deprivationist arguments for their view on abortion.

What all this suggests is that pro-lifers do not think that the wrongness of killing and the badness of death are very closely related—at least, not if the “badness of death” is measured in terms of the deprivation of positive subjective experiences.

This is important for the following reason: the comparison between spontaneous abortion and induced abortion relies crucially on one specific similarity: they both involve the same deprivation to the individual. Both individuals lose the large majority of their lives, and this is supposed to be what makes spontaneous abortion as pressing for the pro-lifer as induced abortion (and more so, once the numbers are added). But, if the wrongness of killing is not very closely tied to the badness of death, then the fact that both are similarly deprived (and hence the badness of death is roughly the same for each) may be of negligible relevance. Simply put, my argument runs thus:

The main similarity between babies or fetuses killed by abortion and those whose lives are ended in miscarriage is that they are both deprived of the same subjective goods. 26

However, deprivation of subjective goods is not the primary determinant of the wrongness of killing.

If 1 and 2, then the main similarity between abortion and miscarriage has little to do with the wrongness of killing.

Hence, the main similarity between abortion and miscarriage has little to do with the wrongness of killing.

If this is right, then drawing attention to this similarity between abortion and miscarriage does little to persuade the pro-lifer that they should give both equal attention. But, it would help if we had (a) some motivation for premise 2 and (b) an alternative account of the wrongness of killing that pointed toward (even if not explicating precisely) the reason we may be more worried about killing by abortion than death by miscarriage.

McMahan (2002) , in his magisterial volume on the ethics of killing, offers pointers toward both of these.

McMahan calls this sort of account the Harm-Based Account—killing is wrong because of the harm inflicted on the individual, harm being conceived as the loss of future goods. McMahan thinks that a fatal flaw to this account is that it thinks identity is what matters. In fact, according to McMahan, it does not: what matters is prudential unity relations—psychological relations tying an individual’s psychological life together. Hence, McMahan talks of “time-relative interests,” where these are essentially ordinary interests, whose importance is augmented or discounted, depending on the strength of the psychological connections between an individual at different times. 27

McMahan goes on to suggest that the Time-Relative Interest Account of the wrongness of killing is likewise deficient, however, at least for persons. Why is this? McMahan says that both the Harm-Based Account and the Time-Relative Interest Account have the implication that killing can be more or less wrong depending on the quality of the victim’s life . 28 This, McMahan says,

profoundly offends our sense of the moral equality of persons…The common view, in short, is that the wrongness of killing persons does not vary with such factors such as the degree of harm caused to the victim, the age, intelligence, temperament, or social circumstances of the victim, whether the victim is well liked or generally despised, and so on. ( 2002 , 234–5)

McMahan dubs this the Equal Wrongness Thesis.

The Equal Wrongness Thesis is intuitively plausible. Human equality, and its relevance to fundamental inviolable rights, are popular ethical ideas, on which it seems reasonable to base ethical opinion in the absence of countervailing considerations. Note that if it is true, then premise 2 of the above argument is true: if all killings are in some sense equally wrong, 29 specifically if they are equally wrong regardless of the quality of the anticipated goods in an individual’s life, then the wrongness of killing cannot be dependent on the deprivation of one’s future. Pro-lifers do not need to prove the Equal Wrongness Thesis to respond to the arguments of Ord et al.—they just need to show that there is a plausible reason for their discrepant approaches toward abortion and miscarriage. The Equal Wrongness Thesis is certainly at least plausible.

McMahan goes on to suggest an alternative account that can explain the pro-lifer’s discrepant attitudes, along with a number of other ethical difficulties. It is, therefore, a fruitful theory, and one that I believe accords very well with our intuitions. McMahan suggests the following:

If the killing of persons is always equally wrong, and if all persons are of equal worth, the wrongness of killing may be a function of the worth of the person (rather than of the value of the person’s subsequent life)…a person, a being of incalculable worth, demands the highest respect. To kill a person…is an egregious failure of respect for the person and his worth. It is to annihilate that which is irreplaceable, to show contempt for that which demands reverence…Killing is, in short, an offence against what might be called a requirement of respect for persons and their worth. ( 2002 , 242) 30

McMahan eventually settles on a Two-Tiered Account, according to which the killing of persons is wrong for these sorts of reasons, but for those below the threshold of personhood and the threshold of respect, the wrongness of killing is governed by the Time-Relative Interest Account.

Let us give a few clarifications on this account. First, on this account, “the worth of the victim is entirely independent of the value…of the contents of his possible life in the future” ( 2002 , 243). Hence, it supports premise 2 of my argument. Second, it supports the Equal Wrongness Thesis, since it says that all killings of persons are, in a basic sense, equally wrong.

Third, it does not say that, all things considered, all killings of persons are equally morally wrong, despite appearances. McMahan explains this more carefully: “Despite my choice of label, the Equal Wrongness Thesis does not imply that the wrongness of killing persons never varies. It is compatible with that thesis to recognize that the wrongness of killing can vary in ways that are consistent with the fundamental moral equality of persons” ( 2002 , 235). He goes on to describe a number of ways in which the wrongness of killing can vary: more people killed, worse motivation, intention rather than foresight, and so on. The crucial point of equality is, as I wrote above, that it does not vary according to the worth of the victim (since all victims are equally valuable) or the worth of the victim’s life (since this is irrelevant, on this account).

McMahan defends the respect account of the wrongness of killing at greater length, but let me add some additional motivations for this thesis:

First, as described, it is an account that best fits our intuitions about the fundamental moral equality of human beings, and the connection between the equality of human beings and their most basic rights.

Second, it explains why the right to life is inviolable, as opposed to being potentially expendable, depending on the potential benefits. The International Covenant on Civil and Political Rights 31 says that the right to life is not violable, even in time of public emergency threatening the life of the nation, for example. This, of course, fits with our intuitions regarding the impermissibility of killing, even if it were possible to save more lives (as with the innocent healthy person who is killed to save five lives with organ transplants). 32 Those of us who are opposed to capital punishment and torture (among other things) may find the generation of inviolable rights on the basis of respect especially intuitive as well. It connects these rights in a plausible way with the absolute or infinite worth of the individual.

Zylberman (2016) has a helpful discussion of the concept of human dignity and its connection to these rights. Zylberman first quotes Kant: “In the kingdom of ends everything has either a price or a dignity. What has a price can be replaced by something else as its equivalent; what on the other hand is raised above all price and therefore admits of no equivalent has a dignity” ( Zylberman, 2016 , 204).

Zylberman then describes some implications of this view: in particular, that human dignity can never be traded away, even for something else with dignity, and hence results in an absolute prohibition on certain kinds of conduct, such as torture. This means it can also explain the equal wrongness of killing. The respect account can plausibly claim that human life is priceless, or infinitely valuable, and hence that all human beings are equally valuable. If the wrongness of killing is tied to their value, it can explain the equal wrongness of killing.

Third, it takes seriously our special status as persons rather than just sentient beings, connecting this in a plausible way to our inviolable right to life.

Fourth, it has strong historical precedent (and therefore the intuitive support from the “democracy of the dead,” as Chesterton put it): the U.S. Declaration of Independence ties together our equality and the unalienable right to life, 33 and the Universal Declaration of Human Rights, in its opening line, reminds us that “recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world.” Article 7 gives: “All are equal before the law and are entitled without any discrimination to equal protection of the law.” Arguably, liberal democracy is founded on a concept like respect, along with its moral implications. As we saw earlier, the Christian tradition on which our conception of rights and equality is historically grounded ( Spencer, 2016 ; Holland, 2019 ) has generally emphasized the “sacredness”—the inviolability due to respect—of human life. 34

Fifth, it makes a great deal of sense to many wrong actions which do not seem to harm anyone in a way that is appreciable to the victim. There are many things which are wrong but from which no one necessarily consciously suffers as a result. 35 For example, desecrating someone’s grave, deliberately contradicting or desecrating your loving, caring mother’s dying wish, privately laughing at another’s misfortune, cheating on one’s partner, secretly putting pork in a devout Muslim’s meal, watching child pornography, cannibalism, necrophilia, consenting to sell oneself into slavery, and so on. 36 That these wrongs disrespect the victim rather than “harming” them seems the best explanation of their wrongness. 37

Sixth, it explains our intuitions about particularly aggravated killings: for example, racially motivated or particularly degrading killings.

Finally, it fits very naturally with the pro-life view, which in its standard form says that the right to life is inviolable. Since the allegation is that the pro-life view has an inconsistency, this is a helpful virtue for the pro-lifer.

This account of killing has a lot to commend it. Now how does it affect our central question? In this next section, I suggest that as a result of this account of the wrongness of killing, there are different norms for killing and letting die.

Here, I largely set aside the question of the extent to which intention to harm is important. To go into the literature on intention would take us too far afield, but it is certainly possible that the intention to harm is part of what makes killing necessarily disrespectful. In that sense, intention may well be a substantial part of my argument here. If so, my argument would neatly integrate and explain why intention is so important to the distinction. If not, my argument still works.

All I add here, therefore, is to say that it is deeply intuitive that intention makes an enormous difference to the morality of an action. To take a very simple example: it is permissible to perform actions foreseeing the death of civilians in wartime, so long as the action taken fulfills certain other strict criteria. By contrast, intentionally targeting civilians is a war crime. Foreseeing the death of a person when adjusting a policy to save five others is OK. By contrast, killing someone to use their organs for transplants is not. Examples could be multiplied endlessly, but the intuition is strong. Since, as we see, the intention in performing an abortion and in allowing a miscarriage is (usually) very different, there is an obvious reason to treat them discrepantly. What I propose is that the respect theory of the wrongness of killing may channel the role of intuition in these cases—intentionally killing a fetus is inherently disrespectful, while foreseeing the death of the fetus is not necessarily disrespectful.

The argument at this point is, again, very simple. Killing is inherently disrespectful—a violation of human dignity. It is impossible to (intentionally) kill in a way that respects the value of the victim’s life, and hence there is an absolute prohibition on it. 38 Now failing to save is not inherently or necessarily disrespectful. There are many reasons why one might fail to save someone that do not necessarily represent a failure of respect for that individual. 39 Hence, there is no absolute prohibition on failing to save. Saving someone from natural death often is a duty for various reasons—indeed, sometimes the failure to do so is a failure of respect. But, it is not necessarily so. Hence, different norms apply to each: killing is always wrong, for the reason that it is necessarily a failure of respect. Failing to save may or may not be wrong, depending on the details of the individual case.

At this point, we can respond to an objection that has been raised by a number of writers. Simkulet, for example, argues that once scenarios involving killing and letting die are made similar in every other respect, there is no moral difference between the two. In response, note that even if true , this does nothing to damage my argument. For one of the relevant factors that need to be made similar for the two scenarios to be comparable is a failure of respect . Killing, I have said, necessarily involves this. Failing to save only contingently does so. Where failing to save does constitute the same kind of failure of respect, it may well be just as wrong as killing. 40 But, in cases where failing to save is not borne out of a failure of respect, it is not necessarily as wrong. This result is all that is needed for my overall argument to succeed. Where failing to save is not a failure of respect, clearly there are other norms that govern such situations—and these norms may be significantly different from the norms governing killing. 41

Let us motivate the idea that the respect account generates differing norms a little more. First, I highlighted earlier how many of the bad features of abortion emphasized by pro-lifers are bad specifically because they are degrading , or because they disrupt a respectable part of the natural order (such as the love between members of a family). This adds more weight to the idea that killing (particularly in abortion) involves a lack of respect, while spontaneous abortion lacks those same features.

Second, the general reason we fail to save people is clearly not a lack of respect; it is a lack of resources. Indeed, it is impossible to save everyone. This creates a clear asymmetry with killing: it is entirely possible never intentionally to kill anyone, yet it is completely impossible to save everyone. If it is impossible to save everyone, then it is wildly implausible to claim that failing to save someone necessarily involves a failure of respect.

Third, the infinite value of human life easily translates into a principle on killing: do not kill. What is the equivalent principle of saving life? Because it is not possible to save everyone, it is difficult to see what this could be. Certainly, it is difficult to see what plausible principle this could involve. Put another way: it is possible for us to achieve infinite utility in the realm of killing: simply by not killing at all. But, it is harder to understand what infinite utility would look like when it comes to saving lives.

Fourth, further intuition supports different norms for the two cases. We would potentially kill in order to prevent a murder or genocide. This seems to be broadly the only situation killing would gain widespread support. 42 However, we would not at all countenance the thought of killing one person to save more people from another disease (as in the transplant case). This suggests that there are different norms for the two situations.

Fifth, it is almost universally agreed that killing and letting die are morally different. This is clear in Anglo-American law and international law, among many other (perhaps all) jurisprudential systems. Hence, there are many reasons to think that the norms governing each situation are distinct.

What norms could govern failing to save? I do not aim to set out a comprehensive algorithm: just to list some of the possibilities and their plausibility. First, of course, a failure to save can be a failure of respect, which would make that failure prohibited. Aside from this, we could be guided by many considerations:

How much such persons might be able to contribute to the rest of society (e.g., if they have the cure for cancer).

How many expected years of life that person has remaining.

How many vulnerable people that person has depending on them (including if they are pregnant).

Whether that person belongs to a protected class of human beings disproportionately affected by systemic injustice.

How likely the person is to survive the intervention.

Prudential unity considerations (i.e., the time-relative interest account).

Whether that person would prefer to live or die.

Other competing goods—not just saving lives, but other cultural goods and other sources of human flourishing, and the prevention of harm and/or misery.

The proximity of the person.

Special relationships we might have with the person.

The circumstances and cause of death: including whether the person is being killed by another person or by natural disease, and the reason for their being killed (if homicide).

Most of us already believe that at least some of these are relevant to whether we have a duty to save someone’s life, and if so, which lives we should save (given limited resources). So, our intuitions already support this sort of reasoning— even though most of us agree that humans are equal and have equal rights. This supports the idea that an equal right to life is primarily a negative right, as described. Most people endorse an account like this: killing is equally wrong across all persons, but failing to save can be right or wrong depending on a wide variety of factors. As some examples of the above: most people agree that you should save someone who has a cure for cancer over someone who does not; the idea of spending limited resources to preserve as many years of life as possible (hence discriminating between persons) is not only widely accepted but built into the foundations of health economics and resource distribution; most people think you have a duty to save your child over someone else’s child, and so on.

We even tacitly grant that competing goods that can justify not saving someone’s life include goods that do not save the life of another person. Almost every country in the world, and almost every person in the developed world, at least, spends a large amount of money or other resources on things that do not save lives, when they could have contributed toward saving a life. 43 At the same time, we would still all grant that killing people in the developing world to make money for those same goods is clearly morally monstrous.

Almost everyone endorses policies that result in more deaths because they think that when it comes to saving lives, this can be weighed against other competing goods. As an example related to abortion: most people support delayed childbearing in order to improve equality between men and women, even though the subsequent delayed childbearing leads to increased maternal mortality ( Koch, 2012 ). 44

Likewise, it is uncontroversial that a central part of medicine is not only the preservation of life but also the alleviation of misery. Those in health care realize they could save more lives by shifting all the money from misery prevention into life preservation; almost no one thinks we should do so.

All that is needed for my argument is the theoretical result that some of these considerations can outweigh numbers alone. If it is permissible to save one young child over two 90-year-olds with terminal illnesses, then we have granted that equality and the equal wrongness of killing do not mean that we cannot discriminate on any other basis when it comes to saving lives. And, that is enough to generate the possibility that preventing abortion or curing cancer ought to be a bigger priority than preventing miscarriages. If it may be permissible to stop an ethnic genocide against 10,000 people over a disease killing 10,001, the principle is proven.

To use an example that may be more (though far from entirely) analogous to abortion, suppose a disease has been unleashed, and you can save only:

1) A group of ten young girls, deeply integrated into their local communities, whose death would be extremely painful and degrading, and would lead to much misery for both the victims and perennially for their families.

2) A disparate collection of eleven hermits with no social contact at all, who would be missed by no one, who are in comas, and who would die quickly and painlessly.

I am not going to adjudicate in this scenario; I do not need to. All I need is to show that the answer is not obvious , even for those of us completely committed to human equality. We would all be agreed that killing the hermits is absolutely wrong, no matter the benefit. But, we might reasonably think that allowing a greater number of hermits to die to save the tightly bonded community is permissible. And that is enough to show that numbers are not the only consideration when it comes to saving lives.

We have, then, a plausible theoretical explanation for why different norms governing the different situations apply. We also have a wide range of intuitions regarding practices mostly already adopted, that suggest we can discriminate when it comes to saving lives. We also firmly believe that this is compatible with our deep commitment to human equality. The view that different norms govern killing and letting die appears to have robust justification.

We are now in a position to respond to Ord’s pre-emption of this strategy. Ord says that the difference between killing and letting die does not matter; he can sidestep this question by directly comparing miscarriage to other natural conditions leading to many deaths, such as cancer. As we can now see, this move does not work. Not only does the difference between killing and letting die justify saving fewer lives from killing than from natural causes, a close examination of the wrongness of killing and the wrongness of failing to save reveals very different norms governing each case. Saving lives involves asking many questions other than simply: “how many lives?” Indeed, there are compelling arguments to show that sometimes saving fewer lives is reasonable. With this established in principle, it is not clear what argument Ord can make. He has to show not only that spontaneous abortion kills a large number of people, but that no reasonable overall assessment could justify spending more on other causes. That argument looks to be very difficult to make.

Essentially, there are two different questions. Why prioritize the prevention of abortion over the prevention of miscarriage? For all the reasons I have given throughout this paper. Ord suggests there is a second question: why prioritize the prevention of cancer, coronavirus, and so on, over the prevention of miscarriage? The answer is because the norms for killing and saving are different, and the norms for saving do not require treating every life saved as equivalent, nor do they require treating every life saved as being of overriding importance to other social concerns (such as the prevention of misery, the preservation of community, and so on). We are able to preserve the equality of human beings and the equal wrongness of killing, at the same time as triaging when it comes to saving lives on the basis of a wide range of other considerations.

We can also now respond to Simkulet’s (2019) allegation that pro-life responses appealing to discriminating factors between lives can justify abortion. This would perhaps be the case if abortion were merely a failure to save. However, since abortion is (at least typically) killing, 45 Simkulet’s response fails.

It is worth briefly responding to the anticipated objection that when it comes to pro-life lobbying, all work is rescuing, rather than refraining from killing. Pro-lifers are not just refraining from killing; they are rescuing people, even if from killing rather than from disease or misfortune. This is true, and it is important: after all, it follows that pro-lifers cannot save everyone from being killed, and for the reasons explained here they therefore have no infinitely strong obligation (as they do against murder) to try and save children from abortion. Failing to advocate against abortion is not necessarily a failure of respect (though it can be). However, this consideration does not impugn my argument. I have not argued that pro-lifers must advocate against abortion at the expense of anything else or that failing to do so necessarily results from a lack of respect tantamount to killing. Rather, I have claimed and argued that the reasons for saving lives from abortion are significantly stronger than the reasons for saving lives from miscarriage, and hence can justify a greater focus on the former. I make no argument here for how strong those reasons are in absolute terms, and whether they suffice to make abortion a pre-eminent social and political priority. 46

All that is needed for my argument to work, therefore, are the following claims:

1) The norms for killing and letting die are distinct.

2) Norms other than the equality and inviolability of persons (and numbers) are applicable in the case of letting die.

3) Some of these norms in the case of letting die can outweigh numerical considerations.

I submit that each of these is not only plausible, but widely believed. In this paper, I have sought to elucidate some of the theoretical and intuitive justification behind them. It might be that Ord, Berg, and Simkulet believe that pro-life efforts are still disproportionate when all these norms are taken into account: but that requires more than just a statement of the numbers involved. It takes even more to show that the typical pro-lifer’s priorities are unjustifiable . I suspect that this cannot be shown.

As I have shown, this account of the wrongness of killing has significant implications for our moral interpretation of killing and failing to rescue, and hence for our prioritization of preventing killing and preventing natural death. The consequences of this are many, and not only limited to the abortion debate. Within the abortion debate, it gives the pro-lifer powerful resources for explaining why they prioritize the prevention of abortion over the prevention of miscarriage. It could also give powerful resources for explaining why a pro-lifer might save a young child over multiple frozen embryos in a “burning building” scenario. 47 It could help to explain part of the reason killing is much more morally serious than letting die, and hence, it could reinforce a significant disanalogy between abortion and Thomson’s violinist scenario. 48 It could explain the wrongness of abortion in cases of fatal fetal anomaly, where the child is not expected to enjoy significant positive conscious experience for a long period of time, and perhaps also the wrongness of euthanasia in general. Finally, it could explain the wrongness of early abortion, which many find counterintuitive. As we have seen, the respect account explains the wrongness of certain actions whose victim is never cognisant of the action or its consequences (such as using child pornography). If actions can be seriously wrong—as a violation of respect—without the victim ever experiencing that harm, then perhaps the primary objection to the plausibility of the pro-life view is dispatched, namely, that it is not plausible that a completely unconscious being is worthy of serious moral consideration.

More generally, this account of the wrongness of killing could be part of the reason why we almost universally treat killing as more serious than letting die and take more measures to rescue people from killing than from natural disease or misfortune . Since this distinction is a central element of much Anglo-American (and other) jurisprudence, it has considerable importance. The distinction between killing versus letting die is also, of course, relevant for all sorts of ethical debates, and does not need to be explained in detail here. The account can also assist us in prioritizing the prevention of deaths by killing and by natural causes. The distinction between killing and letting die remains respectable.

Alvaré , H. M. 2011 . Abortion, sexual markets and the law. In Persons, Moral Worth, and Embryos: A Critical Analysis of Pro-Choice Arguments , ed. S. Napier , 255 – 79 . Dordrecht, The Netherlands : Springer .

Google Scholar

Google Preview

Annas , G. J. 1989 . At law: A French homunculus in a Tennessee court . Hastings Center Report 19 ( 6 ): 20 – 2 .

Berg , A. 2017 . Abortion and miscarriage . Philosophical Studies 174 ( 5 ): 1217 – 26 .

Blackshaw , B. P. and D. Rodger . 2019 . The problem of spontaneous abortion: Is the pro-life position morally monstrous? The New Bioethics 25 ( 2 ): 103 – 20 .

Bovens , L. 2006 . The rhythm method and embryonic death . Journal of Medical Ethics 32 ( 6 ): 355 – 6 .

British Pregnancy Advisory Service. 2020 . The inconceivable grief of baby loss is, unfortunately, something many individuals experience, including fertility patients [Post on Instagram] Available: https://www.instagram.com/p/CEJYu6Whpi1/ .

Christensen , A. 2018 . Abortion and deprivation: A reply to Marquis . Journal of Medical Ethics 45 ( 1 ): 22 – 5 .

Colgrove , N. 2021 . Miscarriage is not a cause of death: A response to Berg’s “abortion and miscarriage” . Journal of Medicine and Philosophy 46 ( 4 ): 394 – 413 .

Colley , E. , S. Hamilton , P. Smith , N. V. Morgan , A. Coomarasamy and S. Allen . 2019 . Potential genetic causes of miscarriage in euploid pregnancies: A systematic review . Human Reproduction Update 25 ( 4 ): 452 – 72 .

Condic , M. L. 2011 . A biological definition of the human embryo. In Persons, Moral Worth, and Embryos: A Critical Analysis of Pro-Choice Arguments , ed. S. Napier , 211 – 35 . Dordrecht, The Netherlands : Springer .

Cunningham , R. M. , M. A. Walton , and P. M. Carter . 2018 . The major causes of death in children and adolescents in the United States . New England Journal of Medicine 379 ( 25 ): 2468 – 75 .

Department of Health and Social Care. 2020 . Abortion statistics 2019: Data tables [On-line] . Available: https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2019 (accessed October 6, 2020).

Derbyshire , S. W. G. , and J. C. Bockmann . 2020 . Reconsidering fetal pain . Journal of Medical Ethics 46 ( 1 ): 3 – 6 .

Fergusson , D. M. , L. J. Horwood , and J. M. Boden . 2013 . Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence . Australian & New Zealand Journal of Psychiatry 47 ( 9 ): 819 – 27 .

Friberg-Fernros , H. 2019 . Defending the two tragedies argument: A response to Simkulet . Journal of Medical Ethics 45 ( 6 ): 417 – 8 .

Gallup. 2020 . Abortion . Available: https://news.gallup.com/poll/1576/abortion.aspx (accessed February 6, 2023).

Greasley , K. 2017 . Arguments about Abortion: Personhood, Morality and Law . Oxford, United Kingdom : Oxford University Press .

Guttmacher Institute. 2019 . Induced abortion in the United States [On-line] . Available: https://www.guttmacher.org/sites/default/files/factsheet/fb_induced_abortion.pdf (accessed February 6, 2023).

Hague , W. 2008 . William Wilberforce: The Life of the Great Anti-Slave Trade Campaigner . London, United Kingdom : Harper Perennial .

Haskell , M. 1992 . Dilation and extraction for late second trimester abortion . Presentation at the National Abortion Federation Risk Management Seminar, September 13, 1992 .

Hassold , T. , N. Chen , J. Funkhouser , T. Jooss , B. Manuel , J. Matsuura , A. Matsuyama , C. Wilson , J. A. Yamane, and P. A. Jacobs . 1980 . A cytogenetic study of 1000 spontaneous abortions . Annals of Human Genetics 44 ( 2 ): 151 – 78 .

Holland , T. 2019 . Dominion: The Making of the Western Mind . London, United Kingdom : Little, Brown .

Jarvis , G. E. 2017 . Early embryo mortality in natural human reproduction: What the data say [version 2] . F1000Research 5 : 2765 .

Johnston , W. R. 2007 . Data on “partial-birth” abortion in the United States [On-line] . Available: http://www.johnstonsarchive.net/policy/abortion/pba.html (accessed February 6, 2023).

———. 2020 . Historical abortion statistics, PR China [On-line] . Available: http://www.johnstonsarchive.net/policy/abortion/ab-prchina.html (accessed February 6, 2023).

Karalis , E. , V. M. Ulander , A. M. Tapper , and M. Gissler . 2017 . Decreasing mortality during pregnancy and for a year after while mortality after termination of pregnancy remains high: A population-based register study of pregnancy-associated deaths in Finland 2001-2012 . British Journal of Obstetrics and Gynaecology 124 ( 7 ): 1115 – 21 .

Koch , E. 2012 . Women’s education level, maternal health facilities, abortion legislation and maternal deaths: A natural experiment in Chile from 1957 to 2007 . PLoS One 7 ( 5 ): e36613 .

Koch , E. , P. Aracena , S. Gatica , M. Bravo , A. Huerta-Zepeda, and B. C. Calhoun . 2012 . Fundamental discrepancies in abortion estimates and abortion-related mortality: A reevaluation of recent studies in Mexico with special reference to the International Classification of Diseases . International Journal of Women’s Health 4 : 613 – 23 .

Koch , E. , M. Bravo , S. Gatica , J. F. Stecher , P. Aracena , S. Valenzuela and I. Ahlers . 2012 . Sobrestimación del aborto inducido en Colombia y otros países latinoamericanos . Ginecologia y Obstetricia de Mexico 80 ( 5 ): 360 – 72 .

Lacantius. Divine institutes. Trans. W. Fletcher. Rev. and ed. K. Knight. New Advent [On-line]. Available: http://www.newadvent.org/fathers/07011.htm (accessed March 31, 2023).

Marino , T. A. 2008 . Natural embryo loss—A missed opportunity . American Journal of Bioethics 8 ( 7 ): 25 – 7 .

Marquis , D. 1989 . Why abortion is immoral . Journal of Philosophy 86 ( 4 ): 183 – 202 .

McMahan , J. 2002 . The Ethics of Killing: Problems at the Margins of Life . Oxford, United Kingdom : Oxford University Press .

Miller , C. 2021 . Maternal mortality from induced abortion in Malawi: What does the latest evidence suggest? International Journal of Environmental Research and Public Health 18 : 10506 .

———. Forthcoming . Human equality arguments against abortion . Journal of Medical Ethics .

Miller , C. , and A. Pruss . 2017 . Human organisms begin to exist at fertilization . Bioethics 31 ( 7 ): 534 – 42 .

NaPro Technology. 2020 . References [On-line] . Available: https://www.naprotechnology.com/references.htm (accessed February 6, 2023 ).

New York Times. 1997 . An abortion rights advocate says he lied about procedure [On-line] . Available: https://www.nytimes.com/1997/02/26/us/an-abortion-rights-advocate-says-he-lied-about-procedure.html (accessed February 6, 2023 ).

Ord , T. 2008 . The scourge: Moral implications of natural embryo loss . American Journal of Bioethics 8 ( 7 ): 12 – 9 .

Our World in Data. 2020 . Number of births and deaths per year, World, 1950 to 2099 [On-line] . Available: https://ourworldindata.org/grapher/births-and-deaths-projected-to-2100 (accessed February 6, 2023 ).

Pohlhaus , J. R. , and R. M. Cook-Deegan . 2008 . Genomics research: World survey of public funding . BMC Genomics 9 : 472 .

Popinchalk , A. , and G. Sedgh . 2019 . Trends in the method and gestational age of abortion in high-income countries . BMJ Sexual and Reproductive Health 45 ( 2 ): 95 – 103 .

Rodger , D. , B. P. Blackshaw and C. Miller . 2018 . Beyond infanticide: How psychological accounts of persons can justify harming infants . The New Bioethics 24 ( 2 ): 106 – 21 .

Sedgh , G. , J. Bearak , S. Singh , A. Bankole , A. Popinchalk , B. Ganatra , C. Rossier , et al. . 2016 . Abortion incidence between 1990 and 2014: Global, regional, and subregional levels and trends . The Lancet 388 ( 10041 ): 258 – 67 .

Simkulet , W. 2017 . Cursed lamp: The problem of spontaneous abortion . Journal of Medical Ethics 43 ( 11 ): 784 – 91 .

———. 2019 . The two tragedies argument . Journal of Medical Ethics 45 ( 5 ): 304 – 8 .

Spencer , N. 2016 . The Evolution of the West: How Christianity Has Shaped Our Values . London, United Kingdom : SPCK .

Supreme Court of the United States. 2007. Gonzales v. Carhart, 550 U.S. 124.

The Economist . 2019 . The fertility business is booming [On-line] . Available: https://www.economist.com/business/2019/08/08/the-fertility-business-is-booming (accessed February 6, 2023 ).

Warren , E. 2019 . Comments at Democratic presidential primary debate, June 26, 2019 [On-line] . Available: https://www.youtube.com/watch?v=YB3z7XKX-cE (accessed February 6, 2023 ).

Zylberman , A. 2016 . Human dignity . Philosophy Compass 11 ( 4 ): 201 – 10 .

This appears to have been first published by Annas (1989) , who cites Leonard Glantz as the inspiration.

Berg and Ord seem to suggest this; Simkulet, by contrast, insists that pro-lifers must be unaware or simply morally monstrous.

Condic (2011) offers a fuller discussion.

See also Miller (2021) .

Around 9,000,000 are reported each year in China alone, for example—though for obvious reasons China is likely to have a higher abortion rate than average. See Johnston (2020) .

As opposed to “euploidy,” where the normal number of chromosomes is present.

These proportions may differ by country, depending on the extent to which malnutrition and poorer control of chronic conditions and infections may cause miscarriage. So it may be that—given that these estimates come largely from the developed world—the proportion due to aneuploidy globally is actually less than for induced abortion.

Even this is a bit simplistic: dying with a chromosomal anomaly does not mean dying from the anomaly. After all, some people with Turner Syndrome live long lives: it by no means entails intrauterine death.

At least, on the pro-life view. That they are moral equals is highly debatable on the common alternative view that our moral worth is grounded in our psychological capacities. See Miller (Forthcoming) .

I specify human organisms since it is even possible that genetic changes may be so radical as to constitute a separate species—after all, the genetic makeup of different species is largely quite similar. That said, I think it is plausible that the overwhelming majority of cases in question are human, and in many cases constitute organisms.

I say “necessarily,” because it may be wrong in some cases: if the intention is to cause suffering, for example. But, if there is a valid reason—for example, wanting to delay childbearing until a point that having a disabled child is very likely but not intended—then it is not inherently wrong.

Incidentally, it is also a reason pro-lifers have no significant duty to take particular measures to avoid genetic anomalies recommended by some authors, such as avoiding the rhythm method (which may—speculatively—lead to older and more genetically vulnerable gametes conceiving) or using sperm sorting. Bovens (2006) makes the former argument. Likewise, changing the timing of pregnancy is probably unhelpful from the perspective of preventing deaths, since changing the timing of pregnancy will likely result in a different child.

See the figure cited for genetics research here, and Colgrove’s (2021) estimate for money spent on fertility research.

Colgrove (2021) makes similar points, while Marino (2008) presents a summary of current research.

“The notion that the Partial-Birth Abortion Ban Act furthers any legitimate governmental interest is, quite simply, irrational” ( Supreme Court of the United States, Gonzales v. Carhart , 550 U.S. 124 (2007) , Ginsburg, J., dissenting, 24).

See also the International Covenant on Civil and Political Rights, Article 23.

See UDHR, Article 6; ICCPR, Article 16.

Colgrove (2021) makes this point independently.

One might also think that the money spent lobbying for abortion justifies higher spending on abortion insofar as more money is needed to create a “level playing field.” Intuitively, the more money invested in the transatlantic slave trade, the greater the necessity to spend money and resources fighting against it.

Advocates of the transatlantic slave trade claimed that keeping the trade legal was the best way to keep it “safe”—banning it would only lead to poorer conditions on the now unregulated ships. See Hague (2008) .

The same applies from the fifth point, namely, that more resources are needed to create a level playing field regardless of whether the political impetus behind abortion makes it more degrading.

A reviewer points out that apathy toward miscarriage is also a moral wrong and could be seen the same way. But the pro-lifer under attack by Ord et al. need not be apathetic to miscarriage. They could think miscarriage is a bad thing and spend some resources trying to prevent it, while spending more opposing abortion.

For example, Christensen (2018) and subsequent correspondence.

A baby with anencephaly is not able to experience much value—she cannot experience higher pleasures than many animals, and experiences them for a much shorter time. And yet pro-lifers generally consider abortion of anencephalic children to be a very morally serious violation of their right to life, even if much more understandable and exculpable than abortion for, say, career reasons.

In the view of many pro-lifers, which is the relevant view in this case.

By which I mean, goods that are able to be apprehended and appreciated by the subject.

McMahan notes that the Harm-Based Account (and presumably the Time-Relative Interest Account by implication) is ordinarily associated with the denial of a moral distinction between killing and letting die—but it may be that other accounts of the wrongness of killing do permit such a distinction.

The latter clause is important—McMahan does not deny that some killings can be more or less wrong, but that any variation must depend on factors other than the value of the victim or her life—for example, number of killings, motivation, intention, and so on.

We explicate exactly what this could mean shortly.

This fits neatly with the conception of human dignity as a “rank” that requires respect—this rank could explain the equal wrongness of killing, among other things. Zylberman (2016) has a helpful summary of the issues raised here.

The legal codification of the civil and political rights declared in the Universal Declaration of Human Rights.

McMahan writes that it is “permissible to sacrifice an animal for the greater benefit of other animals or persons … In the case of persons, however, we believe that it is wrong to kill one person as a means of preventing the killing of a greater number of others” ( 2002 , 246–7).

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” In his most famous speech during the Civil War to end slavery, the Gettysburg Address, Lincoln relies heavily on this theme.

The account also fits neatly with Kant’s account of human dignity and worth.

Clearly, it is possible (in many cases, likely) that someone is consciously harmed by these actions—but this is not necessarily so.

Rodger, Blackshaw, and Miller (2018) offer some further examples in the context of the beginning of life.

Jonathan Haidt’s The Righteous Mind is a good introduction to a kind of common sense, pluralist morality that admits questions of sacredness and respect even in the absence of harm; see Part II in particular. Haidt shows how these notions are endemic to our thinking whether or not we are religious—ideas of respect and sacredness are a part of everyday moral thought, even if increasingly by the former label.

A reviewer points out that assisted suicide or euthanasia might be thought compatible with respect. This helpfully demonstrates how the respect account of the wrongness of killing is precisely that to which pro-lifers subscribe: they typically believe that killing oneself or another person is wrong even when solicited. All I need is for this theory to be plausible on the pro-life view. Even if one supposes that suicide and euthanasia are not necessarily disrespectful, the premise could easily be modified: killing someone without their consent is necessarily a failure of respect.

The most obvious is that doing so is metaphysically impossible, which—as I have argued—may be the case for many miscarriages.

Just as, for example, intending to kill may be as serious as killing, even if one fails.

It goes without saying that pro-lifers do not typically fail to prevent miscarriages deliberately, or out of a lack of respect, but out of a lack of resources.

There are a few fringe cases, such as in Re A (conjoined twins) , which do not make a significant difference to this argument.

This is not to say that I condone the widespread greed that also characterizes many people in the developed world. I do think that we have a duty to give much more to save lives in the developing world than we currently give; I just do not think that duty necessarily overrides any duty or permission to spend resources on goods that do not save lives.

Again, of course, by contrast, killing a woman of the same age to promote equality of women is not permissible.

As Greasley (2017) has compellingly argued.

For full transparency, I have no hesitation in saying that I believe a relatively compelling argument can be given for this as well.

In short, because the norms on saving lives are governed by many factors other than human equality: and these other factors are present in such cases. This does not impugn the ultimate equality between the embryos and the child.

Greasley offers a comprehensive analysis of the significance of this distinction—while letting die is frequently permitted in many jurisdictions, killing has far more stringent restrictions. Hence, since abortion appears to be killing rather than letting die, the restrictions on it are far more stringent than they would be if abortion were merely a failure to rescue, as Thomson’s violinist experiment might imply.

Email alerts

Citing articles via.

• Recommend to your Library

Affiliations

• Online ISSN 1744-5019
• Print ISSN 0360-5310
• Copyright © 2024 Journal of Medicine and Philosophy Inc.
• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Advertising
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Numbers, Facts and Trends Shaping Your World

Read our research on:

Full Topic List

Regions & Countries

• Publications
• Our Methods
• Short Reads
• Tools & Resources

Read Our Research On:

• America’s Abortion Quandary

2. Social and moral considerations on abortion

Table of contents.

• 1. Americans’ views on whether, and in what circumstances, abortion should be legal
• Public views of what would change the number of abortions in the U.S.
• A majority of Americans say women should have more say in setting abortion policy in the U.S.
• How do certain arguments about abortion resonate with Americans?
• In their own words: How Americans feel about abortion 
• 3. How the issue of abortion touches Americans personally
• Acknowledgments
• Methodology

Relatively few Americans view the morality of abortion in stark terms: Overall, just 7% of all U.S. adults say abortion is morally acceptable in all cases, and 13% say it is morally wrong in all cases. A third say that abortion is morally wrong in  most  cases, while about a quarter (24%) say it is morally acceptable most of the time. About an additional one-in-five do not consider abortion a moral issue.

There are wide differences on this question by political party and religious affiliation. Among Republicans and independents who lean toward the Republican Party, most say that abortion is morally wrong either in most (48%) or all cases (20%). Among Democrats and Democratic leaners, meanwhile, only about three-in-ten (29%) hold a similar view. About four-in-ten Democrats say abortion is morally  acceptable  in most (32%) or all (11%) cases, while an additional 28% say abortion is not a moral issue. 

White evangelical Protestants overwhelmingly say abortion is morally wrong in most (51%) or all cases (30%). A slim majority of Catholics (53%) also view abortion as morally wrong, but many also say it is morally acceptable in most (24%) or all cases (4%), or that it is not a moral issue (17%). And among religiously unaffiliated Americans, about three-quarters see abortion as morally acceptable (45%) or not a moral issue (32%).

There is strong alignment between people’s views of whether abortion is morally wrong and whether it should be illegal. For example, among U.S. adults who take the view that abortion should be illegal in all cases without exception, fully 86% also say abortion is always morally wrong. The prevailing view among adults who say abortion should be legal in all circumstances is that abortion is not a moral issue (44%), though notable shares of this group also say it is morally acceptable in all (27%) or most (22%) cases. 

Most Americans who say abortion should be illegal with some exceptions take the view that abortion is morally wrong in  most  cases (69%). Those who say abortion should be legal with some exceptions are somewhat more conflicted, with 43% deeming abortion morally acceptable in most cases and 26% saying it is morally wrong in most cases; an additional 24% say it is not a moral issue. 

The survey also asked respondents who said abortion is morally wrong in at least some cases whether there are situations where abortion should still be legal  despite  being morally wrong. Roughly half of U.S. adults (48%) say that there are, in fact, situations where abortion is morally wrong but should still be legal, while just 22% say that whenever abortion is morally wrong, it should also be illegal. An additional 28% either said abortion is morally acceptable in all cases or not a moral issue, and thus did not receive the follow-up question.

Across both political parties and all major Christian subgroups – including Republicans and White evangelicals – there are substantially more people who say that there are situations where abortion should still be  legal  despite being morally wrong than there are who say that abortion should always be  illegal  when it is morally wrong.

Asked about the impact a number of policy changes would have on the number of abortions in the U.S., nearly two-thirds of Americans (65%) say “more support for women during pregnancy, such as financial assistance or employment protections” would reduce the number of abortions in the U.S. Six-in-ten say the same about expanding sex education and similar shares say more support for parents (58%), making it easier to place children for adoption in good homes (57%) and passing stricter abortion laws (57%) would have this effect. 

While about three-quarters of White evangelical Protestants (74%) say passing stricter abortion laws would reduce the number of abortions in the U.S., about half of religiously unaffiliated Americans (48%) hold this view. Similarly, Republicans are more likely than Democrats to say this (67% vs. 49%, respectively). By contrast, while about seven-in-ten unaffiliated adults (69%) say expanding sex education would reduce the number of abortions in the U.S., only about half of White evangelicals (48%) say this. Democrats also are substantially more likely than Republicans to hold this view (70% vs. 50%). 

Democrats are somewhat more likely than Republicans to say support for parents – such as paid family leave or more child care options – would reduce the number of abortions in the country (64% vs. 53%, respectively), while Republicans are more likely than Democrats to say making adoption into good homes easier would reduce abortions (64% vs. 52%).

Majorities across both parties and other subgroups analyzed in this report say that more support for women during pregnancy would reduce the number of abortions in America.

More than half of U.S. adults (56%) say women should have more say than men when it comes to setting policies around abortion in this country – including 42% who say women should have “a lot” more say. About four-in-ten (39%) say men and women should have equal say in abortion policies, and 3% say men should have more say than women. 

Six-in-ten women and about half of men (51%) say that women should have more say on this policy issue. 

Democrats are much more likely than Republicans to say women should have more say than men in setting abortion policy (70% vs. 41%). Similar shares of Protestants (48%) and Catholics (51%) say women should have more say than men on this issue, while the share of religiously unaffiliated Americans who say this is much higher (70%).

Seeking to gauge Americans’ reactions to several common arguments related to abortion, the survey presented respondents with six statements and asked them to rate how well each statement reflects their views on a five-point scale ranging from “extremely well” to “not at all well.” 

The list included three statements sometimes cited by individuals wishing to protect a right to abortion: “The decision about whether to have an abortion should belong solely to the pregnant woman,” “If legal abortions are too hard to get, then women will seek out unsafe abortions from unlicensed providers,” and “If legal abortions are too hard to get, then it will be more difficult for women to get ahead in society.” The first two of these resonate with the greatest number of Americans, with about half (53%) saying each describes their views “extremely” or “very” well. In other words, among the statements presented in the survey, U.S. adults are most likely to say that women alone should decide whether to have an abortion, and that making abortion illegal will lead women into unsafe situations.

The three other statements are similar to arguments sometimes made by those who wish to restrict access to abortions: “Human life begins at conception, so a fetus is a person with rights,” “If legal abortions are too easy to get, then people won’t be as careful with sex and contraception,” and “If legal abortions are too easy to get, then some pregnant women will be pressured into having an abortion even when they don’t want to.” 

Fewer than half of Americans say each of these statements describes their views extremely or very well. Nearly four-in-ten endorse the notion that “human life begins at conception, so a fetus is a person with rights” (26% say this describes their views extremely well, 12% very well), while about a third say that “if legal abortions are too easy to get, then people won’t be as careful with sex and contraception” (20% extremely well, 15% very well).

When it comes to statements cited by proponents of abortion rights, Democrats are much more likely than Republicans to identify with all three of these statements, as are religiously unaffiliated Americans compared with Catholics and Protestants. Women also are more likely than men to express these views – and especially more likely to say that decisions about abortion should fall solely to pregnant women and that restrictions on abortion will put women in unsafe situations. Younger adults under 30 are particularly likely to express the view that if legal abortions are too hard to get, then it will be difficult for women to get ahead in society.

In the case of the three statements sometimes cited by opponents of abortion, the patterns generally go in the opposite direction. Republicans are more likely than Democrats to say each statement reflects their views “extremely” or “very” well, as are Protestants (especially White evangelical Protestants) and Catholics compared with the religiously unaffiliated. In addition, older Americans are more likely than young adults to say that human life begins at conception and that easy access to abortion encourages unsafe sex.

Gender differences on these questions, however, are muted. In fact, women are just as likely as men to say that human life begins at conception, so a fetus is a person with rights (39% and 38%, respectively).

Analyzing certain statements together allows for an examination of the extent to which individuals can simultaneously hold two views that may seem to some as in conflict. For instance, overall, one-in-three U.S. adults say that  both  the statement “the decision about whether to have an abortion should belong solely to the pregnant woman” and the statement “human life begins at conception, so the fetus is a person with rights” reflect their own views at least somewhat well. This includes 12% of adults who say both statements reflect their views “extremely” or “very” well. 

Republicans are slightly more likely than Democrats to say both statements reflect their own views at least somewhat well (36% vs. 30%), although Republicans are much more likely to say  only  the statement about the fetus being a person with rights reflects their views at least somewhat well (39% vs. 9%) and Democrats are much more likely to say  only  the statement about the decision to have an abortion belonging solely to the pregnant woman reflects their views at least somewhat well (55% vs. 19%).

Additionally, those who take the stance that abortion should be legal in all cases with no exceptions are overwhelmingly likely (76%) to say only the statement about the decision belonging solely to the pregnant woman reflects their views extremely, very or somewhat well, while a nearly identical share (73%) of those who say abortion should be  illegal  in all cases with no exceptions say only the statement about human life beginning at conception reflects their views at least somewhat well.

When asked to describe whether they had any other additional views or feelings about abortion, adults shared a range of strong or complex views about the topic. In many cases, Americans reiterated their strong support – or opposition to – abortion in the U.S. Others reflected on how difficult or nuanced the issue was, offering emotional responses or personal experiences to one of two open-ended questions asked on the survey. 

One open-ended question asked respondents if they wanted to share any other views or feelings about abortion overall. The other open-ended question asked respondents about their feelings or views regarding abortion restrictions. The responses to both questions were similar. 

Overall, about three-in-ten adults offered a response to either of the open-ended questions. There was little difference in the likelihood to respond by party, religion or gender, though people who say they have given a “lot” of thought to the issue were more likely to respond than people who have not. 

Of those who did offer additional comments, about a third of respondents said something in support of legal abortion. By far the most common sentiment expressed was that the decision to have an abortion should be solely a personal decision, or a decision made jointly with a woman and her health care provider, with some saying simply that it “should be between a woman and her doctor.” Others made a more general point, such as one woman who said, “A woman’s body and health should not be subject to legislation.” 

About one-in-five of the people who responded to the question expressed disapproval of abortion – the most common reason being a belief that a fetus is a person or that abortion is murder. As one woman said, “It is my belief that life begins at conception and as much as is humanly possible, we as a society need to support, protect and defend each one of those little lives.” Others in this group pointed to the fact that they felt abortion was too often used as a form of birth control. For example, one man said, “Abortions are too easy to obtain these days. It seems more women are using it as a way of birth control.” 

About a quarter of respondents who opted to answer one of the open-ended questions said that their views about abortion were complex; many described having mixed feelings about the issue or otherwise expressed sympathy for both sides of the issue. One woman said, “I am personally opposed to abortion in most cases, but I think it would be detrimental to society to make it illegal. I was alive before the pill and before legal abortions. Many women died.” And one man said, “While I might feel abortion may be wrong in some cases, it is never my place as a man to tell a woman what to do with her body.” 

The remaining responses were either not related to the topic or were difficult to interpret.

Sign up for our weekly newsletter

Fresh data delivery Saturday mornings

Sign up for The Briefing

Weekly updates on the world of news & information

• Christianity
• Evangelicalism
• Political Issues
• Politics & Policy
• Protestantism
• Religion & Abortion
• Religion & Politics
• Religion & Social Values

Americans see many federal agencies favorably, but Republicans grow more critical of Justice Department

9 facts about americans and marijuana, nearly three-quarters of americans say it would be ‘too risky’ to give presidents more power, biden nears 100-day mark with strong approval, positive rating for vaccine rollout, biden begins presidency with positive ratings; trump departs with lowest-ever job mark, most popular, report materials.

901 E St. NW, Suite 300 Washington, DC 20004 USA (+1) 202-419-4300 | Main (+1) 202-857-8562 | Fax (+1) 202-419-4372 |  Media Inquiries

Research Topics

• Email Newsletters

ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

© 2024 Pew Research Center

• Skip to main content
• Keyboard shortcuts for audio player

Reproductive rights in America

7 persistent claims about abortion, fact-checked.

Jaclyn Diaz

Koko Nakajima

Nick Underwood

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5. Jim Watson/AFP via Getty Images hide caption

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5.

Since the Supreme Court's 1973 Roe v. Wade decision ruled that women have a constitutional right to end their pregnancies, proponents and opponents of abortion rights have worked to own the conversation over the issue.

In 2019, the Centers for Disease Control and Prevention reported that 629,898 legal induced abortions were reported across the United States.

Lingering claims circulate about abortion, including about the safety of it, who gets abortions and even who supports or opposes access to abortion.

Below, seven popular claims surrounding abortion get fact-checked.

According to the Pew Research Center's polls , 37% of Americans want abortion illegal in all or most cases.

But an even bigger fraction — around 6 in 10 Americans — think abortion should be legal in all or most cases.

Current abortion rates are lower than what they were in 1973 and are now less than half what they were at their peak in the early 1980s, according to the Guttmacher Institute , a reproductive health research organization that supports abortion rights.

In 2017, pregnancy rates for females age 24 or below hit their lowest recorded levels, reflecting a long-term decline in pregnancy rates among females 24 or below.

Overall, in 2017, pregnancy rates for females of reproductive age hit their lowest recorded levels, with 87 pregnancies per 1,000 females ages 15 to 44, according to the Guttmacher Institute.

The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973, according to the CDC.

An analysis of data from 2013 to 2018 showed the national case-fatality rate for legal induced abortion was 0.41 deaths per 100,000 legal induced abortions, lower than in the previous five years.

The World Health Organization said people obtaining unsafe abortions are at a higher risk of death. Annually, 4.7% to 13.2% "of maternal deaths can be attributed to unsafe abortion," the WHO said. In developing regions of the world, there are 220 deaths per 100,000 unsafe abortions.

Trans and nonbinary people have undergone abortions as well.

The Guttmacher Institute estimates in 2017 an estimated 462 to 530 transgender or nonbinary individuals in the U.S. had abortions. That same year, the CDC said, 609,095 total abortions were carried out in the country.

The Abortion Out Loud campaign has collected stories from thousands of people who have had an abortion. Included are stories from trans and nonbinary people who have had an abortion — such as Jae, who spoke their experience.

"Most abortions in 2019 took place early in gestation," according to the CDC . Nearly 93% of abortions were performed at less than 13 weeks' gestation.

Abortion pills, which can typically be used up to 10 weeks into a pregnancy, made up 54% of abortions in 2020. These pills were the primary choice in the U.S. for the first time since the Food and Drug Administration approved the abortion drug mifepristone more than 20 years ago.

State legislatures have been moving to adopt 20-week abortion bans, with abortion opponents claiming fetuses can feel pain at that point. Roughly a third of states have implemented an abortion ban around 20 weeks .

But this contradicts widely accepted medical research from 2005. This study , published in the Journal of the American Medical Association , concluded that a fetus is not capable of experiencing pain until somewhere between 29 or 30 weeks.

Researchers wrote that fetal awareness of pain requires "functional thalamocortical connections." Those thalamocortical fibers begin appearing between 23 and 30 weeks' gestational age, but the capacity for pain perception comes later.

The argument against abortion has frequently been based on religion.

Data shows that the majority of people who get an abortion have some sort of religious affiliation, according to the most recent Guttmacher Institute data , from 2014.

The Pew Research Center also shows that attitudes on whether abortion should be legal vary among evangelical Protestants, mainline Protestants and Catholics.

Roe v. Wade and the future of reproductive rights in America

Here's what could happen now that roe v. wade is overturned.

• Supreme Court
• Roe v. Wade

• Latest Latest
• The West The West
• Sports Sports
• Opinion Opinion
• Magazine Magazine

Perspective: How the Utah Supreme Court could turn family law principles upside down

In a novel argument, planned parenthood says parental rights include ending the life of an unborn child.

By Camille S. Williams

In its challenge to Utah’s abortion law, Planned Parenthood Association of Utah argues that a woman must have access to abortion in order to exercise her right to parent and to determine her family’s composition. In simple terms, Planned Parenthood contends that parental rights include the right to end the life of unwanted unborn children. That is an astonishing claim completely antithetical to the long-recognized parental duties to provide for and to protect their children.

The claim is based on Planned Parenthood’s assertion in its complaint that views about when life begins are “inherently religious and spiritual.” What follows logically from that assertion is that whether the unborn child is alive or not is entirely dependent upon the mother’s religious or spiritual views. Biology doesn’t work that way, and determining whether a human being is living is important in law. Utah’s abortion law is based on the fact that life begins at conception, and it resembles the nonreligious, nonspiritual American Law Institute’s pre-Roe and Doe Model Penal Code .

In truth, Planned Parenthood’s dispute with the state is not about when life begins, but about when unborn human beings should be protected by law. Human life is an intrinsic good recognized by the state’s public policy “to encourage all persons to respect the right to life of all other persons ... including all unborn persons.”

The Utah law — SB 174 — does not give unborn children rights that would prevent all abortions. But it does value and protect human life by limiting abortion to medically indicated procedures which preserve the mother’s life and health (as with ending an ectopic pregnancy or removing a dead fetus); or when pregnancy is forced (as in cases of rape or incest); or when the baby has a severe brain defect or other lethal conditions the baby can’t survive.

Planned Parenthood of Utah’s novel view that parental rights include the right to end a life, as the state points out in its submission to the Utah Supreme Court, is only one of seven claims contending that Utah’s abortion regulation violates “eleven different state constitutional provisions that alone or in various combinations impliedly guarantee a right to abortion.”

Since the state constitution never explicitly mentions abortion, the state notes that some “PPAU claims involve double-implied rights — implying a right to abortion from another implied right.”

In other words, Planned Parenthood of Utah is arguing that even though the constitution does not say anything about a right to determine who will be part of your family, such a right can be implied by the language of the constitution. The language of that implied right can then be interpreted as implying a Roe-like right to abortion, making any tie to the constitutional language doubly tenuous.

Surprisingly, Planned Parenthood’s family composition claim relies on a case called In Re J.P. In that case, the Utah Supreme Court openly criticized Roe v. Wade for relying on “a ‘right to privacy’ not mentioned in the Constitution to establish other rights unknown at common law.” The court differentiated its own reasoning from that of the Roe court by explaining “that the parental liberty right at issue in this case is fundamental to the existence of the institution of the family, which is ‘deeply rooted in this Nation’s history and tradition,’ and in the ‘history and culture of Western civilization.’ This rooting in history and the common law validates and limits the due process protection afforded parental rights, in contrast to ... innovations undisciplined by any but abstract formulae.”

Planned Parenthood of Utah’s doubly implied rights don’t arise directly from the language of the state constitution, nor from the common law, nor from the history of the nation.

The major issue decided by the recent Utah Supreme Court opinion was whether to leave in place the injunction preventing the law’s enforcement while the case is litigated. However, its 78-page majority decision suggests an openness to hear claims similar to those made in cases Dobbs overturned. Planned Parenthood seeks to ground in the Utah Constitution a Roe-like outcome (little or no protection of the unborn until viability) based on arguments used in Casey (women rely on abortion in order to access other rights and opportunities). In a footnote, the court indicated that “the relevant constitutional inquiry is whether the Utah Constitution protects a right that might be infringed by a law unduly restricting abortion access, not whether the Utah Constitution contains an ‘implied right to abortion.’” That appears to be a distinction without a difference.

The court began its analysis by stating that the “Utah Constitution enshrines principles, not application of those principles,” and that the court’s “proper inquiry focuses on what principle the constitution encapsulates and how that principle should apply.” It then illustrated how it might identify a principle not explicitly listed in the Utah Constitution by examining Planned Parenthood’s and the state’s discussion of parental rights and family composition. The court concluded that the rights the In Re J.P . case “recognized are bound together by a basic principle: autonomy over decisions concerning one’s family.”

What is troubling, though, is that the court was silent about another principle embedded in the case: The child is not to be reduced to the status of chattel (property) “to be treated or mistreated by his or her parents according to their pleasure.” In fact, in parental rights termination cases, the court has stated that “the child’s welfare is the ‘paramount consideration.’ That principle does not imply that the child’s welfare is the sole consideration, to the exclusion of parental rights ... (but it does mean) that parental rights, though inherent and retained, are not absolute. ...”

How the court will weigh such conflicting constitutional principles is unclear. Historically, when the principle of parental autonomy conflicts with the principle that the child’s welfare is paramount and the principle that parents have a duty to protect the welfare of children, the state has harmonized those principles by finding life-affirming ways to protect children and to support parents’ efforts to fulfill their parental duties. Only in the worst situations, and generally after reunification efforts have failed, does the state move to terminate parental rights of parents proven to be unfit or incompetent due to conduct or conditions seriously detrimental to the child. The state then seeks safe, permanent homes for those children. In contrast, Planned Parenthood’s approach seeks no such balance. In effect, it advances an unbalanced view that in order to achieve a preferred family composition it is permissible to end the life of one child in favor of parenting another child either born or not yet conceived.

The state cannot dictate the details of family life in an effort to maximize protection of unborn and other vulnerable children. Utah law attempts the minimal, preventing parents from harming or killing their children.

In contrast, Planned Parenthood of Utah urges the state’s courts to reinstate Roe’s abortion policy by finding an unenumerated natural parental or familial right under the Utah Constitution for mothers to end the lives of their unwanted unborn children — essentially treating them like chattel in the guise of a right to parent or a right to family formation. As Dobbs demonstrated, however, a parental right to kill the unborn is not deeply rooted in our nation’s history. Abortion is not deeply rooted in Utah’s history, either.

In practical terms, the state is limited in its ability to protect the child before birth and in its ability to protect the mother’s health. However, Utah’s abortion law is a step in the right direction because it values the lives of mothers and children and seeks to protect both — a goal consistent with family law principles deeply embedded in the history of our state and our nation.

Camille S. Williams is an attorney practicing in Provo who has published articles related to women’s and family issues. The views expressed are her own.

• Update Preferences
• Give Online
• Give by Mail or Phone
• Give through Donor Advised Fund
• Donate your Vehicle
• Estate Planning
• Campaign 2024
• Trump Shooting
• Trump Trials
• Israel-Hamas War
• International
• Election Center 2024
• WORLD Opinions
• SIGN UP FOR NEWSLETTER

Family & Society

On abortion, trump is his own worst enemy, the former president’s pro-life betrayal is morally wrong and electorally foolish.

Former President Donald Trump (left) and Sen. J.D. Vance at a campaign event in North Carolina last week Associated Press/Photo by Chuck Burton

Full access isn’t far.

We can’t release more of our sound journalism without a subscription, but we can make it easy for you to come aboard.

Get started for as low as $3.99 per month.

Current WORLD subscribers can log in to access content. Just go to "SIGN IN" at the top right.

Already a member? Sign in.

I cannot think of a worse moment in my life to be a fervent pro-life voter. There is no denying the obvious: Abortion is popular in America.

Every time abortion has been on state ballots, it has lost decisively.

Now, seeking to expand their coalition for a win in November, Donald Trump and J.D. Vance are pivoting to what is virtually indistinguishable from where many moderate Democrats were on abortion in the 1990s. From an unclear statement by former President Trump that his administration will be “ great for women and their reproductive rights ” to Sen. Vance saying that Trump would veto a national abortion ban , the Trump-Vance ticket is doing the opposite of what pro-life voters (who make up a massive proportion of the Republican coalition) expect of it. Trump has made other dispiriting comments elsewhere.

Trump and Vance deserve to hear from the pro-life community. On the off chance that someone related to their campaign sees this, please read this sentence slowly: The Trump campaign stands only to lose support by backpedaling on abortion.

On the one hand, Trump and Vance are doing entirely rational things. They want to win, and how do you win? You lessen the grip on the issues that cost you votes. It is a rationally motivated activity to look at abortion’s popularity in America and think, “We cannot be on the wrong side of the majority.”

I understand it even as I reject it.

But we should recognize what’s at stake at its starkest: Trump is betraying voters who have the most reason to vote for him and the most reason to stay home because of him in 2024.

Trump was a historic pro-life president in his first term. We need not rehash all the reasons why. He deserves our gratitude for what his administration accomplished. He also deserves to hear the reality that there are many, many pro-life voters in America for whom this issue alone is the moral red line. If Trump is viewed as positively expanding access to abortion, there will be massive electoral ramifications. I know many devout evangelical Christians who are stalwart conservatives who will not vote for Trump if he is viewed as positively pro-abortion.

There are two layers of betrayal in what is occurring.

There’s a moral betrayal to Trump’s calculation, namely, a betrayal at the heart of the Republican Party’s original commitment to oppose “ barbarism ” (as its original 1856 platform said of slavery) when it comes to human dignity. Human dignity is a principle that should defy majoritarian sentiment.

There’s also a commonsense betrayal. Trump and his team are no fools, and they should know better than to use careless rhetoric when no federal policy change is likely. Their language demoralizes and suppresses their base while accomplishing little through actual electoral gain. Neither Democrats nor Republicans have the votes at the federal level to make any of their wishes on abortion come true. Even if the filibuster were gone, there would not be 50 Republican votes for federal legislation since many Republicans take a federalist approach. This is not to discount the error of Trump and Vance trying to sidestep the issue, but the federal legislation angle is largely irrelevant—for now.

Trump and Vance must know they cannot run from protecting the unborn. To do so would be catastrophic and demoralizing for a large swath of those inclined to vote for them. It is one thing to acknowledge legislative realities, but it is another to talk impudently and indifferently.

Trump’s downplaying and obfuscating on abortion and the humiliation of his pro-life base in the process is profoundly misguided. All this triangulation does is serve to depress the pro-life vote. The many Christians who held their nose and voted for Trump because he promised to be pro-life and not enact a progressive agenda are finding themselves left with a Donald Trump who possesses the same tawdry character and who is now sounding like a progressive. Mr. Trump: Please do better than this. And let us state the miscalculation most bluntly: No Trump-skeptic voter is going to look at his easing on abortion and think, “Yes, that is what will cause me to vote for him.” Trump trying to make himself more “moderate” on abortion will not earn him accolades among the determined who hate him.

My suggestion is that Trump must do something to allay the concerns of the pro-life community. Talk about what the executive branch can do to protect life. Offer a list of judicial appointees that demonstrate a pro-life jurisprudence. Use the bully pulpit to talk about why families, babies, and the culture of life are better and more beautiful than a culture of sterility, barrenness, and death. Distinguish yourself from Kamala Harris and Tim Walz’s pro-abortion agenda.

Trump had better offer up something positive, or, once again, he will be his own worst enemy. The parable of Donald Trump is one for whom snatching defeat from the jaws of victory is his brand. Even if Trump and Vance want to sidestep the abortion issue and punt it to state-level politics, they should not give the wrong side the rhetorical wins that pro-abortion forces so badly want. Regardless of debates about federal or state roles, there should always be the argument that fostering a culture of life by loving children is a mark of a decent and humane nation.

If you enjoyed this article and would like to support WORLD's brand of Biblically sound journalism, click here .

Andrew is the managing editor of WORLD Opinions and serves as associate professor of Christian ethics at The Southern Baptist Theological Seminary. He is also a fellow with The Ethics and Public Policy Center. He resides with his family in Louisville, Ky.

These daily articles have become part of my steady diet. —Barbara

Read the Latest from WORLD Opinions

Erin Hawley | Facebook caved under pressure from the Biden-Harris administration, which sought to silence speech it didn’t like

A.S. Ibrahim | The former president’s strategy to win their votes appears to be working

Miles Smith | Harris and her fellow Democrats seek a country made in their image by ridding us of “that little piece of paper”

Jerry Bowyer | What the 818,000 jobs correction shows about our economy and culture

Please wait while we load the latest comments...

Please register, subscribe, or log in to comment on this article.

Related Articles

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• J Med Ethics
• v.26(2); 2000 Apr

The morality of abortion and the deprivation of futures

In an influential essay entitled Why abortion is wrong, Donald Marquis argues that killing actual persons is wrong because it unjustly deprives victims of their future; that the fetus has a future similar in morally relevant respects to the future lost by competent adult homicide victims, and that, as consequence, abortion is justifiable only in the same circumstances in which killing competent adult human beings is justifiable. 1 The metaphysical claim implicit in the first premise, that actual persons have a future of value, is ambiguous. The Future Like Ours argument (FLO) would be valid if "future of value" were used consistently to mean either "potential future of value" or "self-represented future of value", and FLO would be sound if one or the other interpretation supported both the moral claim and the metaphysical claim, but if, as I argue, any interpretation which makes the argument valid renders it unsound, then FLO must be rejected. Its apparent strength derives from equivocation on the concept of "a future of value".

Key Words: Abortion • Future Like Ours • Donald Marquis • potentiality • pro-choice

The Full Text of this article is available as a PDF (75K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

• Marquis Don. Why abortion is immoral. J Philos. 1989 Apr; 86 (4):183–202. [ PubMed ] [ Google Scholar ]
• Cudd Ann E. Sensationalized philosophy: a reply to Marquis's "Why abortion is immoral. J Philos. 1990 May; 87 (5):262–264. [ PubMed ] [ Google Scholar ]
• Norcross Alastair. Killing, abortion, and contraception: a reply to Marquis. J Philos. 1990 May; 87 (5):268–277. [ PubMed ] [ Google Scholar ]
• Flower MJ. Neuromaturation of the human fetus. J Med Philos. 1985 Aug; 10 (3):237–251. [ PubMed ] [ Google Scholar ]

Connection denied by Geolocation Setting.

Reason: Blocked country: Russia

The connection was denied because this country is blocked in the Geolocation settings.

Please contact your administrator for assistance.

• Election 2024
• Govt + Politics
• Environment
• Criminal Justice
• Abortion Policy
• Health Care
• Health Policy

Murrill: ‘Democrats have their facts wrong’ on abortion ban exceptions

By: greg larose - august 21, 2024 9:08 pm.

Attorney General Liz Murrill. (Matthew Perschall/Louisiana Illuminator)

Republican Attorney General Liz Murrill came out in defense of Louisiana’s abortion ban Wednesday, saying on social media that “Democrats have their facts wrong.”

Her remarks drew an immediate and sharp rebuke from one of the state’s leading abortion rights advocates.

Murrill’s comments came a day after three women, including one from Louisiana, spoke at the Democratic National Convention in Chicago about their difficulties obtaining life-saving reproductive health care in states with abortion bans. All three have campaigned for pending Democratic presidential nominee Vice President Kamala Harris.

They included Kaitlyn Joshua of Baton Rouge, who was turned away from two emergency rooms when she miscarried 11 weeks into her pregnancy. Doctors refused treatment because they feared the criminal consequences of Louisiana’s strict abortion ban, she said.  

The state law allows abortions in instances when a pregnant person’s life is in jeopardy or they risk permanent damage to a vital organ, but physicians have said the law lacks enough clarity to ensure they won’t face prosecution.

Murrill challenged Joshua’s perspective on X, the social media platform formerly known as Twitter. She made her statement through her campaign X account, not the official Louisiana attorney general’s account.

“There is nothing in our bipartisan law that prohibits emergency care for someone having a miscarriage or any emergency situation during pregnancy. Nothing. Hard stop,” Murrill wrote.

“In fact, doctors are legally required to care for a pregnant woman who suffers an emergent health crisis, whether that’s appendicitis or a miscarriage,” the attorney general added in a reply to her original post.

State Rep. Mandie Landry, D-New Orleans, an attorney who has represented reproductive health providers, challenged Murrill’s version of the facts. 

“Are you really calling Kaitlyn a liar? And all the women like her who have publicly testified to the same treatment when they were suffering? Despicable,” Landry replied to Murrill’s post.

Who’s Kaitlyn Joshua, the Louisiana woman who spoke at the Democratic National Convention?

Joshua also told the DNC delegates she was unable to obtain prenatal care during the first trimester of her pregnancy, which she said her doctor attributed to Louisiana’s abortion law.

When she was seeking emergency care after going into extremely early labor, doctors were reluctant to provide her with a drug to help treat her miscarriage because it’s the same one used for medication abortions, Joshua said.

“I was in pain, bleeding so much my husband feared for my life,” Joshua said. “No woman should experience what I endured, but too many have.”

Landry also noted that Murrill and the anti-abortion group Louisiana Right to Life helped defeat a proposal from the Legislature to add more clarity to the exceptions in the state’s abortion ban.  

“​​Louisiana may have a law on the books re: life of the mother exception but it’s not followed because hospitals are afraid of YOU. Sit this one out,” Landry responded to Murrill.

The New Orleans legislator is among Louisiana’s delegates attending the Democratic National Convention.

GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX

Once again, the Democrats have their facts wrong. There is nothing in our bipartisan law that prohibits emergency care for someone having a miscarriage or any emergency situation during pregnancy. Nothing. Hard stop. 🧵1/2 #DNC2024 #lalege — Liz Murrill (@LizMurrillforLA) August 20, 2024

Are you really calling Kaitlyn a liar? And all the women like her who have publicly testified to the same treatment when they were suffering? Despicable. #lalege https://t.co/FETDmKOu2Q — Mandie Landry (@votelandry) August 21, 2024

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our website. AP and Getty images may not be republished. Please see our republishing guidelines for use of any other photos and graphics.

Greg LaRose

Greg LaRose has covered news for more than 30 years in Louisiana. Before coming to the Louisiana Illuminator, he was the chief investigative reporter for WDSU-TV in New Orleans. He previously led the government and politics team for The Times-Picayune | NOLA.com, and was editor in chief at New Orleans CityBusiness. Greg's other career stops include Tiger Rag, South Baton Rouge Journal, the Covington News Banner, Louisiana Radio Network and multiple radio stations.

Louisiana Illuminator is part of States Newsroom , the nation’s largest state-focused nonprofit news organization.

Related News