Abortion and moral equivalence

The Irish Medicines Board (IMB) has warned women against buying the abortion pill RU486 online. RU486 or Mifepristone is widely available in the UK under strict medical supervision but is not authorised for use in Ireland. However Irish women have now started to illegally purchase the pill online avoiding the need to travel to Britain for an abortion. The IMB and customs officers have been monitoring packages coming into Ireland on a continuous basis.

The drug has been promoted by Rachel’s Vineyard, a group which offers weekend retreats for healing after abortion. The group’s director Bernadette Goulding said the drug is used frequently in Ireland. "I've had young women coming to me who would have taken that drug,” she said. “The women would have taken the tablets themselves and aborted at home.” The strictness of Ireland’s anti-abortion laws means that over 6,000 Irish women travel to Britain every year to terminate their pregnancies. Abortion is proscribed by article 40.3.3 of the Irish Constitution which was amended by referendum in 1983 to read “"The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right."

However Ireland is far from being the only country where the abortion debate rages. The UK is examining its first legal change on the subject in twenty years. The Daily Telegraph reports that “hundreds of MPs” are to vote to lower the abortion limit to 20 weeks. Abortion has been legal in Britain (but not Northern Ireland) since 1967 and has allowed abortion under 28 weeks to avoid injury to the mother or existing children. In 1990 the time limit was reduced to 24 weeks for most cases to reflect improving medical technology. Now further advances are driving the push to reduce it again to 20 weeks. Labour pro-lifer Joe Benton said, "I do think many more MPs…will vote for 20 weeks because late abortion seems less acceptable now that the viability of the foetus is much better as a result of advances in medical science."

Despite its reputation as America’s biggest hot button issue, it is pleasing to note that it is not resonating with the southern voters of Virginia despite attempts by Robert G. Marshall to make it the centrepiece of his campaign for the Republican nomination for Senate. Marshall is one of three Republican hopefuls looking to replace retiring Senator John W. Warner. Marshall has tried to exploit the pro-life community telling people they are "not conservative enough" if they support abortion in cases of rape and incest. But a party insider told the Washington Times that if the Republicans focus solely on this issue, they are “going to get our clocks cleaned”.

Here in Australia the abortion debate has been as passionate as anywhere else despite most opinion polls showing overwhelming support for the right of a woman to terminate an unwanted pregnancy. The 2006 decision for the Therapeutic Goods Administration to approve RU486 rather than the Liberal Health Minister Tony Abbott prompted a stormy and emotional parliamentary debate and conscience vote. RU486 is not an abortion drug however, it kills the foetus, though it may have adverse health effects on the mother.

Abbott, a strong Catholic, had publicly criticised the abortion rate in Australia saying in 2004 that 25 percent of all pregnancies end in abortion three quarters of which were funded by Medicare. After that year’s election he announced a desire to limit taxpayer-funded abortion. Abortion is state law in Australia so Abbott could not directly intervene to change abortion law but the federal government could have stopped the Medicare funding. In the end, however Abbott was rebuffed by his boss John Howard who was aware of the potential electoral repercussions. Abbott later said he did not support removing the Medicare safety net and supported abortion that was “safe, legal and rare”.

This is not a view shared by the leaders of Abbott’s Church. Pope John Paul II’s 1995 Evangelium Vitae declared all direct abortion to be a “grave moral disorder”. But the reality is that community views are not so clear cut. As the Jesuit Frank Brennan puts it in his book “Acting on Conscience”, the majority of citizens do not morally equate the “disposing of a beaker full of embryos” with partial-birth abortions on “near viable foetuses”. Problems emerge over the decision of where to draw this line.

Brennan argues that the pro-choice and the pro-life lobbies are actually in agreement in that they both refuse to countenance that there is a moral difference between the two extremes. For the pro-choicers, partial-birth abortion (usually over 20 weeks) is permissible no matter what the tangible and visible effects while the right-to-lifers argue that community revulsion over partial birth procedures should be translated into a blanket ban on all direct abortion. As Brennan says, it becomes a “winner take all argument” where either all is permitted or none.

Brennan also castigated the stance of the American bishops who threatened 2004 Democrat (and Catholic) presidential nominee John Kerry with excommunication for his pro-choice stance. For some US bishops, Kerry’s stance was a greater crime against conscience than non-Catholic George W. Bush’s reluctance to waive executions as governor of Texas or his decision to go to war in Iraq in 2003. These bishops urged Catholics not to vote for Kerry. Brennan pointed out that “singling out voters for Kerry from voters for Bush is so morally selective as to be political, being perceived to be partisan”.

The case against abortion in the US is undermined, says Brennan, by the numbers of Catholics having and performing abortions. Even if Roe v Wade was overturned, it is unlikely that many jurisdictions would recriminalise all abortion from the moment of conception precisely because there is no moral consensus on when a life begins. There is a big difference between the withdrawal of an embryo from the womb and what Brennan emotively calls the “dismembering and killing [of] a near viable foetus who is only days and inches from a life protected by law and respected by society”.

Suicide Tourism: A one way ticket to Euthanasia Central

Germans are flocking across the border to Switzerland looking for the right to die. Switzerland is one of the few European countries where euthanasia is legal. Since 1942, Swiss doctors can terminate a life if three conditions are satisfied: documented proof of the existing disease, the lack of protest from relatives and a signed contract, confirming that the decision is voluntary and invariable. Because the service is not limited to Swiss citizens, a suicidal tourism trade has developed for those who don’t need the money for a return ticket. Four companies have been set up to perform the service for about €5,000 and one of the companies Dignitas say that 120 of their 196 customers in 2006 were from Germany where the laws are tougher.

Germany is not the only jurisdiction that is less forgiving than the Swiss. In the Canadian province of Saskatchewan, Robert Latimer is serving a life sentence for killing his disabled daughter during what he says was an act of compassionate euthanasia. Latimer openly admitted his “guilt” and two juries convicted him of second-degree murder in the 1993 death of his 12 year old daughter, who was a 12 year old quadriplegic functioning at the level of a three-month-old. Latimer killed her by leaving her in his truck with the motor running and a hose from the tail pipe extended into the cab, while the rest of the family was at church. Critics of leniency for Latimer worried that a Supreme Court “soft” decision would send a signal that euthanasia was acceptable. The Supreme Court upheld the life decision in 2001.

Mercy killing is also illegal in India. In 2004, the Andhra Pradesh High Court rejected a plea from K. Venkatesh, a former national chess champion battling a neurological disorder, who asked to be taken off his life support system. Because of Venkatesh’s case and others, an MP named C.K. Chandrappanhas introduced the Euthanasia (Permission and Regulation) Bill, 2007, in the Indian parliament. If passed, it would provide for a humane and painless death of an individual suffering from an incurable disease. “If there is no hope of recovery for a patient, it is only humane to allow him to put an end to his pain and agony in a dignified manner” said Chandrappanhas.

The Indian bill has incurred the wrath of right to life groups such as the Bangalore-based Respect for Life India. They say the bill is unacceptable both from an ethical and moral standpoint. Right to lifers emphasise the “killing” aspect of euthanasia. According to the ACT Right to Life Association in Canberra the choice is stark “for euthanasia to occur, there must be an intention to kill.” They claim palliative care can now effectively relieve almost all severe pain and significantly relieve emotional distress.

But long-time voluntary euthanasia campaigner Philip Nitschke disagrees. Nitschke was instrumental in the short-lived Northern Territories legislation that was the world’s first Voluntary Euthanasia (VE) law in 1996. Under this law a terminally ill person could to get help from their doctor to die. Four of Nitschke’s patients used this law in the eight months before it was overruled in the Federal Parliament. Nitschke believes the law was overturned by “godbotherers” and a fundamentalist, all-denomination Christian lobby that are small in number but large in influence.

Nitschke is a doctor and therefore well aware that euthanasia is not mentioned explicitly in the Hippocratic Oath. The closest it has to say on the subject is “I will give no deadly medicine to any one if asked, nor suggest any such counsel”. Nor is the position of international human rights law on the matter explicit or clearly defined. Article 6(1) of the International Covenant on Civil and Political Rights (ICCPR) provides: “Every human being has the inherent right to life. This right shall be protected by law. No one shall be arbitrarily deprived of his life.” Roman law and later English common law forbade both suicide and assisting suicide.

The arguments around euthanasia took on a new meaning in the 19th century with the availability of anaesthesia. New York was the first legislature to specifically ban the practice. Today some of the most liberal laws apply in the Netherlands where doctors have immunity from prosecution providing they have complied with a number of 'rules of careful practice'. Dutch acceptance of this practice has been put down to a number of factors including a mature public discussion of moral issues, a secular society, a sense of individual responsibility, the Royal Dutch Medical Association's approval, trust for the medical profession and universal medical coverage.

Euthanasia raises ethical, moral, religious, philosophical, legal, constitutional and human rights issues. Common arguments against include the danger that euthanasia is not only restricted to the terminally ill, it can be used as a health care cost containment, people could be pressurised into accepting it, and it is a rejection of the importance and value of human life. Meanwhile those in favour cite the unbearable pain of sufferers, the right to facilitate the end of this suffering and forcing people to stay alive against their wishes. According to deacon Michael Pershin, a priest of the Moscow Patriarchy, “the phenomenon of euthanasia becomes possible when the meaning of life is pleasure”. According to Nitschke, it's "an absolutely vital and important decision that an individual has".