Abortion Essay Example and Tips
TEMPLATE OF ABORTION ESSAY
INTRODUCTION OF ABORTIONS ESSAY
Currently, women have the opportunity to interrupt pregnancy. Contrary to popular belief that abortion is an innocuous operations, fraught with only some pains of conscience, there is also a medical view of this problem. Yes, surgical intervention for abortion is carried out by the most experienced professionals. But none of them know, and analyses of this cannot show what kind of pathogenic microbes inhabit the vagina. Even absolute sterility, in which the doctor works, does not guarantee that the infection will not be transferred from the vagina to the uterus by sterile medical instruments. And what follows will also be difficult to determine in advance – a serious infection, or a slowly and truly progressive disease.
The unemotional statistics maintains that from year to year the number of abortions among first time pregnant women continues to increase. It is known that such an outcome of the first pregnancy represents an extreme danger for the further function of procreation. In 1996, 9.8% of women made abortions, that is, every tenth abortion was performed in a first-rate woman, in 1998 – 12%, in 1999 – 10.3%. Only this year more than 180,000 women aborted their first pregnancy. And this is far from complete data, since mini-abortions were not taken into account, therefore, the true number of women aborting the first pregnancy is even higher.
Abortion is the cessation of pregnancy before the fetus has become viable, that is until it has reached a level of development sufficient for survival outside the mother’s body. This refers to the gestation period of up to 20 weeks, since it is at the twentieth week of the first signs of viability of the fetus. So, we will discuss different methods of abortion.
The spontaneous termination of pregnancy before the fetus has become viable is called spontaneous abortion or miscarriage. Miscarriage is an unintended and usually undesirable outcome of pregnancy, which brings grief to the couple expecting the baby. From 10 to 15% of all pregnancies end in miscarriage, of which 75% – in the first 12 weeks.
Provoked, or artificial, abortion is the deliberate termination of pregnancy before the fetus has become viable. Abortion is done either for medical reasons (to protect the health of the mother) or at her request regardless of the state of health. Almost 27% of all pregnancies in the US end with such abortion. The legality of abortion has been debated for many years. In 1973, the US Supreme Court determined that the fetus is not a person, but only a “potentially living being” and therefore can not have legal protection. The court ruled that abortion is a legitimate procedure if the following conditions are met:
- During the first trimester of pregnancy (the first three months), the question of the expediency of abortion is decided by the woman herself.
- The next three months (second trimester) the decision on abortion must be taken with the consent of doctors and only taking into account medical indications.
- In the last three months of pregnancy (the third trimester), when the fetus is viable, the law prohibits abortion, except when the health and life of the mother is in danger.
The court also ruled that a woman has a priority right before the state in regulating her own sexual relations. A campaign has now been launched to cancel the 1973 decision.
MAIN BODY OF ABORTIONS ESSAY
ABORTION AS A MEDICAL PROCEDURE
INTERRUPTION OF PREGNANCY IN THE FIRST TRIMESTER
Instrumental methods suggest two main stages of abortion: the preparation of the cervix (enlargement of the cervical canal) and the direct removal of the contents of the uterus. Until now, the main method of expanding the cervical canal remains the use of the expander Gegar, and therefore the consequence of this technique are often ruptures, damage to the cervix and uterine walls. These complications can cause massive bleeding (with a wounded uterine artery), as well as the development of local inflammatory processes, cause miscarriages of subsequent pregnancies and uterine rupture in subsequent births.
Emptying the uterus (destruction and removal of the fetal egg) in the first trimester is usually done by curettes using abortion, which is the cause of many early and long-term complications after abortion. The procedure is usually performed in the operating room under general anesthesia or under local anesthesia using sedative medications.
Mini-abortion – vacuum aspiration – is a method that gives a much smaller number of postabortion complications. To remove the contents of the uterus, a plastic or metal cannula or tube and a source of vacuum are used. An electric pump is often used to create a negative vacuum pressure.
Vacuum aspiration requires less analgesia and is accepted by WHO as the best method for producing early artificial abortion.
INTERRUPTION OF PREGNANCY IN THE SECOND TRIMESTER
ABORTION BY INDUCTION
These abortions are performed in late pregnancy. Recently, a lot of experience has been accumulated for the production of prostaglandins. The abortive effect of prostaglandins is due to their ability to influence the smooth musculature of the uterus. These drugs are used intramuscular, and intravenously, as well as in the form of a gel for insertion into the vagina and cervical canal. Preparations of prostaglandins (PG) for the purpose of induction are used at different periods of pregnancy, in isolation or in combination with other drugs.
INTRODUCTION OF HYPERTONIC SALINE
The method was first proposed in 1934 in Japan. The simplicity of the methodology and the relatively low cost played a role in its rapid spread in all countries. The mechanism of action of these solutions has not been fully elucidated to date. It is noticed that the solutions introduced into the uterus disrupt the habitual habitat of the fetus, after which its death quickly comes. Before the ejection of the fetus, 24-36 hours pass.
The first significant drawback of the method is its duration, so now more modern drugs have been used, for example, oxytocin. However, oxytocin in combination with hypertonic salt solution creates conditions for hypernatremia. With renal failure after the administration of the solution in the blood, an extremely high content of sodium and chlorine can be detected. One of the most serious complications of this procedure may be a hypersmolar hypernatricemic coma. Most often this complication develops with a combination of three factors: the presence of initial hypernatremia, the rapid use of sodium chloride solution, the additional use of oxytocin.
As a rule, already during or immediately after the introduction of hypertonic sodium solution, patients rush into bed, ask for water. Then comes lethargy, local convulsions. In addition, as early as the 1960s, complications such as pulmonary and brain edema, sudden cardiac arrest were described.
COMPLICATIONS AFTER ABORTION
As mentioned above, trauma at the very abortion is fraught with ruptures of the cervix, damage to the cervix and the walls of the uterus. These complications can cause massive bleeding, as well as the development of local inflammatory processes, cause the miscarriage of subsequent pregnancies and the rupture of the uterus in subsequent births.
Even if the abortion operation was successful, no guarantee can be given that the infection will not be transferred from the vagina to the uterus. In the case of apparent infection, there is no inflammation with a rise in temperature, or pain. However, this does not prevent bacteria from entering the fallopian tubes and starting destructive activity there. Over time, spikes and infection of the lumen of the tubes are formed, preventing the egg from entering the uterus. However, this obstacle is easily overcome by spermatozoa, as a result of which the fertilization process takes place in the oviduct, and a complex ectopic pregnancy occurs. Its development leads to grave consequences: pipe rupture and bleeding, requiring urgent surgical intervention.
Ectopic pregnancy occurs in about one case of a hundred. The most obvious sign of an ectopic pregnancy is severe pain. Preventing an ectopic pregnancy is impossible. But the probability of its occurrence increases under certain circumstances:
- infectious diseases;
- previous pregnancy – ectopic;
- surgical operations on the fallopian tubes;
- use of intrauterine contraceptives.
Intrauterine pregnancy is difficult to diagnose. Sometimes it takes from several days to several weeks to determine the diagnosis. The analysis on hCG shows the stage of pregnancy, depending on the amount of gonadotropin produced by the body. Usually this analysis is done only if there is a suspicion of ectopic pregnancy. In ordinary circumstances, it is not used. Ectopic pregnancy can not be tolerated, so in such cases, an operation is performed in which the woman loses pregnancy.
If the infection is triggered, the inflammatory processes in the tubes can lead to complete infection of their lumen and subsequent infertility. Treatment of infertility is delayed for many years.
INFLAMMATION OF LIGAMENTS IN THE SMALL PELVIS
Inflammation occurs as a result of an infection that has fallen into the uterus. This disease has not been studied enough, they suffer very many women who have had at least one abortion. Most bundles of nerve fibers, which are the conductors of sexual impulses, are placed between the sacrum and the posterior wall of the uterus, inside the sacro-uterine ligaments. These ligaments, along with the lateral ligaments, connect the uterus to the walls of the pelvis. There are cases when an infection that enters the uterine cavity affects not the uterine tubes, but blood vessels in the walls of the uterus, in the area of the sacro-uterine ligaments, causing inflammation in them. Inflammation of ligaments is a disease that almost does not respond to treatment.
When the activity of the inflammatory process of the ligaments is low, a woman can not experience any ailments, except for a mildly expressed decrease in the sensitivity of the vagina, vulva and clitoris. Sometimes she thinks that sexual coldness is a natural result of mental emotions after an abortion. If the inflammation of the sacro-uterine ligaments increases, pain occurs during intercourse, caused by the friction of the penis about the cervix and the concussion of the vaginal vault.
Many women suffering from inflammation of the sacro-uterine ligaments are familiar with constant low back pain that occur both day and night. As a rule, neither these pains nor the partial loss of sexual sensitivity are associated with a recent abortion, as this surgical operation is considered to be a harmless procedure.
LETHAL OUTCOME FOR ABORTION
Annually from the consequences of abortion, around 230-240 women die. Among the causes of death, the leading place is occupied by purulent-septic complications, bleeding, extragenital pathologies at the time of abortion, traumatic damage of the pelvic organs, anesthesia complications, pulmonary embolism.
Among the risk factors for the development of purulent-septic inflammation after abortion, women with inflammatory diseases of the kidney and urinary system, skin and subcutaneous fat are isolated. In addition, the death rate of women with abortion can be caused by the mistakes of medical staff. And here statistics give out fatal numbers – about a quarter of women die during surgery as a result of unintentional mistakes even by experienced and professional doctors.
When analyzing the factors, it was found that the probability of death during abortion increases in direct proportion to the period of pregnancy. The greatest number of complications is associated with the termination of pregnancy for a period of 10 to 20 weeks, and the woman’s health risk increases with each week. Women aged 30 years die twice as often as in 19 years. Among the low-income strata of the population, mortality after abortion is four times higher. Unmarried women after an abortion die three times more often than married women.
MEDICAL ASPECTS OF CONTRACEPTION AND STERILIZATION
Along with artificial abortion, contraception and sterilization are the forms of medical intervention in human generative function. At present, a woman has an equal right to both abortion and contraception and sterilization. However, these forms of medical intervention are not equivalent. Contraception and sterilization are effective forms of preventing artificial abortions, including illegal ones. Foreign statistics show that widespread use of contraception reduces the number of abortions. In Bulgaria, Hungary, the Czech Republic, Germany, where coverage of modern forms of contraception is 50-60%, the number of abortions became 2-3 times less than those born.
The existing methods of contraception can be divided into two groups. The first, traditional group includes the rhythmic method, which is known in the literature as the calendar, temperature method, interrupted sexual intercourse, mechanical means, chemical with local action. The second group of modern methods include: hormonal or oral contraception, intrauterine devices (IUDs). 50-60 years of XX century – the period of testing and introduction into clinical practice of oral contraceptives. American scientists Y. Pincus and J. Rock allot a number of drugs that suppress ovulation. In the sixties, thanks to the use of flexible plastics, the idea of the German gynecologist R. Ricker was realized, which in 1909 suggested the use of silk threads wound into the ring into the uterus, the time of creation and introduction of polyethylene intrauterine devices type of Lippes loop. It is interesting that despite the fact that it has been widely used for decades, the mechanism of their action remains a mystery.
The difference between modern contraceptive means is the level of their pathological impact on the body. Scientists, on the basis of many years of research, come to the conclusion that the effectiveness of the contraceptive method is proportional to the frequency of adverse reactions and complications caused by the method of contraception. The degree of effectiveness of modern drugs is 10-20 times higher (traditional contraception) and 3-7 times (IUD) compared with traditional methods.
The most effective method of contraception is sterilization – creating artificial obstruction of the fallopian tubes with mini-laparotomy, laparoscopy or hysteroscopy. However, today not only female but also male sterilization (vasectomy) is spreading. Currently, there are two types of sterilization: one of them – with the restoration of generative function (“Filsche clamps”), and the second is the so-called irreversible sterilization. Both types of sterilization are actively promoted, for example in the USA. The journal Demographic Reports (June 1996), published by the Johns Hopkins University (USA) and subsidized by the United Nations Population Fund, details the use of local anesthesia during sterilization, as well as the surgical procedure itself, outlines the existing ligation procedures for fallopian tubes, describes the forms by which you can prepare specialists to perform this procedure, which the journal calls “method number one”. But the question arises: by what method? The answer is obvious: “the number one method” is not only medical innovations, but also the population policy of the Population Fund in relation to a number of countries. Indeed, the relative simplicity of this method (for example, compared with non-surgical sterilization), the irreversible nature of complete suppression of reproductive capacity can serve as a means not only for family planning, but also for the management and control of demographic processes with predefined and very diverse purposes.
ETHICAL AND LEGAL ISSUES OF ABORTION, CONTRACEPTION AND STERILIZATION
Artificial abortion, contraception and sterilization are modern forms of medical intervention in human reproductive capacity. In the XX century, it acquires a massive character and occurs against the background of fundamental changes in its moral assessment and legal status. The civilized world – above all the states of Europe, the United States – is trying to free itself from the tradition in which they existed for almost fifteen centuries. It is a question of the tradition of moral and religious condemnation and the legislative prohibition of abortion. It is known, for example, that fructification was punishable by the death penalty in all European states for several centuries. Over the past forty years, as a result of lengthy discussions and debates, the legislative ban was abolished or weakened to varying degrees in Sweden (1946), England (1967), France (1979), USA (1973), Italy (1978) ), in Spain (1978), in the Netherlands (1981), in Norway (1978). At the same time, there are still states that have not been affected by the legalization of abortions. These are countries with a stable Catholic culture (for example, Portugal).
Since the beginning of the twentieth century, and until now, the issue of legalization of abortions remains an occasion for discussions of specialists, demonstrations of citizens, parliamentary meetings. The severity in discussing abortion remains, despite the fact that this problem is “as old as the world”. Historically, the attitude of a doctor to abortion is one of the first and basic ethical-medical problems that remain relevant today. This is due to the fact that the problem of abortion concentrates in itself the relationship between people at the level of moral, legal, socio-political, religious, scientific consciousness. Having considered the problem of abortion at each of these levels, one can answer the question why it is the main and fundamental problem of modern biomedical ethics.
ETHICAL-MEDICAL LEVEL OF THE PROBLEM OF ABORTION
The question of the attitude of doctors, medical communities and associations to the practice of artificial abortion has its own history and its logic. In this logic, there are two opposite positions. The movement from one of them to the other makes the history of the question of the ethico-medical attitude towards proliferation.
The first position is expressed in the Hippocratic Oath. Among numerous medical manipulations, Hippocrates specifically singles out proliferation and promises: “I will not give any abortive pessary to a woman”. So, in the V century BC, Hippocrates records the position of the medical class about the ethical inadmissibility of physician involvement in the production of an artificial miscarriage. This position is even more important because it directly contradicts the opinion of the great moralists and legislators of Ancient Greece about the natural expediency of abortion. Their views are generalized and expressed by Aristotle, who wrote in Politics: “If a child has to be born in excess of this number in conjugal cohabitation, then one should resort to abortion before the embryo has sensitivity and life”.
The result of a wide discussion in the press of the moral and ethical problems of abortion at the beginning of the current century was the discrimination and breeding of questions about its ethical inadmissibility and criminal punishability.
THE HISTORY OF THE ISSUE OF THE LEGAL STATUS OF ABORTION
As you know, in ancient Greece and ancient Rome, abortion was not considered a crime. Since the II century AD, Christianity spreads the commandment “Thou shalt not kill” and the embryo that is in the womb of the mother. Normally, the decree of the Council of Constantinople of 692 says: “There is no difference, does anyone kill an adult person or creature at the very beginning of its formation”. To the canonical is the judgment of Basil the Great (4th-5th centuries AD): “A fetus deliberately ruined in the womb is subject to conviction as a murder”. These ideas penetrate the secular legislation of European states from the beginning of the Middle Ages. In the VII century, the legislation of the Visigoths establishes the death penalty as punishment for the expulsion of the fetus. This approach is typical for the European legislation of the Middle Ages and New Times.
Under the influence of Christian morality and laws in the XV, XVI, XVII centuries, abortion as a medical operation practically disappears from medical activities. Turning point becomes 1852. After a stubborn struggle at the Paris Medical Academy, under the pressure of blatant statistics of female mortality in cesarean section, abortion again, comes into the number of obstetrical operations in cases of anatomical narrowing of the pelvis in pregnant women. After that, medical science begins to defend other medical indications for artificial abortion, and especially in those cases where pregnancy threatens the mother’s life. The death penalty for fruiting expels from the legislations of European states, while retaining the status of a crime “against life, against the family and public morality.”
The dynamics of legal sanctions – from the death penalty to full legalization raises the question of the reasons for such drastic changes that have taken place over the past hundred years. The answer to this question presupposes reaching the level of socio-political processes.
DEMOGRAPHIC POLICY AND CONTRACEPTION
The possibility of regulating demographic processes at the level of state control over the birth rate was already known to Greek civilization. Aristotle in Politics recommended: “Perhaps … should put an end to procreation rather than property, so that no children are born beyond a certain number. This number could be determined by reckoning with all sorts of accidents, for example with the fact that some marriages will be childless, and if this issue is left unaddressed, which is the case in most of the states, this will inevitably lead to impoverishment of citizens, and poverty is a source of disturbances and crimes”. In the IV-III centuries BC, the question of overpopulation, according to Polybius, is decided in ancient Greece by the restriction of the birth of one or two children in the family. At one time, at least for Aristotle, the most humane means of strict and compulsory observance of this established custom, in comparison with the murder and neglect of newborns, was abortion. For modern civilization, at least at the level of the UN provisions, the position is typical that abortion can not be considered as a method of regulating the birth rate. This method becomes contraception and sterilization – at the level of medical practice, and the principles of “family planning” and “correct reproductive behavior” at the level of ideology.
In the XIX century, the ideological form of justification for the prevention of pregnancy was Malthusianism, which linked all the misfortunes of mankind to an “absolute surplus of people.” English doctor J. Drysem in the middle of the XIX century was one of the first to use these ideas to justify medical methods of preventing conception and the propagation of contraceptive measures. From this time, contraception is considered as one of the means of birth control and is directly associated with the problems of demography in the world and regions.
Currently, in more than 60 countries, maternity and childcare services work together with family planning services at the state level. China, for example, where there is a Ministry of Family Planning, can be considered as an example of state policy in the field of family planning.
In 1952, the International Federation for Family Planning (IPPF) was established. IPPF sets itself the following global goal: at the moment only one third of people of reproductive age have access to family planning: by 2000, the population of the world will grow to 6 billion people, of which 950 million will be married couples capable of childbirth. IPPF is committed to working with governments, UN agencies and other non-governmental organizations to achieve by the year 2000 that at least 450 million couples worldwide plan their families. IPPF operates in six geographical regions: the African region, the Indian Ocean region, the Arab region, East and South-West Asia and Oceania, the Western Hemisphere, Europe. At the same time, financial and moral resources are allocated to those countries that need them most. “Need” is determined primarily by demographic indicators: “the level of fertility, maternal mortality, infant mortality and prevalence of contraceptives”.
The implementation of the “global goal” implies the solution of the following main tasks, among which:
- Propagation of the concept of family planning and provision of services in this area as possible on a larger scale so that everyone can voluntarily, on the basis of information received, choose and apply the appropriate family planning method.
- Respect for the right of the individual and spouses to freely choose the method of family planning in the interests of their own health and children’s health.
- IPPF strongly objects to the use of any form of coercion (direct or indirect) in the choice of the application of family planning methods.
- IPPF does not consider abortion as a method of family planning; contraception is the only method against unwanted pregnancy.
- Observance of cultural traditions in the implementation of family planning policies is ensured by studying local characteristics of population volunteers, who then develop and implement programs and form the basis of national associations.
- IPPF supports the programs of member associations working in parallel or in conjunction with their governments.
The last, sixth, point is very significant in a complex of moral and ethical problems of the regulation of human reproductive function. The existence of international organizations, the International Society for the Improvement of Contraception, the International Family Planning Federation, working with governments at the level of associations in 134 countries raises the question: who is the main subject of birth control in a state demographic policy – a woman, a family or a state and international organizations? Is it ethical and in what cases is the regulation of the childbearing function in the scales of social and public administration, any socio-political or international control?
Obviously, the principle of the Constitution of the Regional Council: “non-participation of an association or a person representing it in a discriminatory policy with respect to race, creed, color, political opinion or gender” is absolutely not an accidental condition for membership in the IPPF-Europe. Contraceptive methods of birth control, especially sterilization, in the hands of politicians who share discriminatory principles of any kind, can result in unpredictable consequences for the human population, before which all “demographic explosions” known in human history will fade.
SOCIO-POLITICAL ASPECTS OF THE ABORTION PROBLEM
Most researchers believe that the main reason for the legalization of an artificial miscarriage is a massive “epidemic” increase in the number of abortions, which under the unfavorable conditions of the “underground” maimed and carried off a huge number of lives. This point of view has its reasons, but there are also disadvantages. Its logic is analogous to the judgment: if pathology acquires a mass character, then it must turn into a “norm”. In addition, this point of view presupposes the following question: what are the reasons for this?
Answering this question, for a long time it was believed that the increase in the number of artificial miscarriages was stimulated by economic grounds – heavy material conditions, poverty. But these arguments could not withstand criticism already in times, when statistics testified to an almost equal number of abortions among the wealthy strata of the population and in low-income families.
At the beginning of the 20th century, a sociopolitical approach to the problem of abortion was very influential. In 1914, Lieberman asserted: “Give a woman equal to a man in society, increase respect for her personality, destroy contempt for the illegitimate mother and her children, create conditions that ensure the existence of all children born, recognize the right to motherhood and protect it, educate in the younger generations a sense of respect for the institution of motherhood, support every mother during pregnancy and feeding the child – and there will be no need for criminal repression to preserve population growth… and then comes the blissful time when doctors do not have to resort to it (abortion) … and will not (with rare and minor exceptions) apply it”.
Paradoxically, the conditions that, according to Lieberman, should lead to the elimination of the need for artificial abortion, on the contrary, have become a new powerful reason for the growth of this need. Equal to the men position of women in society, their inclusion in socially useful labor activities, caring for a career, i.e. socially-active way of life, the needs of modern social production in women’s labor are factors that ensure a constant and guaranteed high level of the number of abortions.
Against the backdrop of socio-political factors, the psychoemotional motif of abortion looks very conditional: “shame for sin,” “fear of shame,” which is more likely to work in countries with a stable religious culture, although it is naturally inappropriate to talk about truly religious motives for such actions. The motives of the psychoemotional level are filled with new content – fear of public opinion, adaptation to social standards.
One of them is the organizational structure of healthcare, which provides for the existence of special areas that provide for the production of abortions, the development of medical methods for artificial abortion, anesthesia, the training of special medical personnel. Modern technological comfort of artificial termination of pregnancy, its universal availability, free-of-charge – favorable conditions not only for production, but also a guarantee of sustainable reproduction of abortion practices.
These factors, mutually complementing each other, could not and can not exist in a moral-philosophical vacuum. At present, the most influential form of moral and philosophical justification for abortion is the liberal one.
LIBERAL APPROACH TO THE PROBLEM OF ABORTIONS
If the legislation of the states of Europe and America prohibiting medical practice of abortions right up to the first half of the 20th century was formed under the influence of moral and religious establishment, the modern legislation that legalizes abortion has as its basis a liberal ideology. The liberal justification for abortion is based on two principles. The first is the right of a woman to dispose of her body. The second is the denial of the personal status of the fetus.
The first principle – “the right of a woman to dispose of her body” – won a place in European culture with difficulty. Its first frontiers are the so-called medical indications for abortion, i.e. specific medical cases, for example, an anatomically narrow pelvis, or fetal hydrocephalus, when the birth of a child puts the life of the mother in danger. Gradually, there was an expansion of medical indications, they began to include diseases of the heart, kidneys, tuberculosis, mental illnesses, hereditary diseases, etc.
In the first half of the 19th century, the notion of “social testimony” came into circulation, which at first included rape, intercourse by deception, excessive need. Gradually, the scope of the concept expands, and it begins to include “husband’s desire,” “unfavorable family life,” “the desired number of children.” As a result, the civilized world comes to recognize the right of a woman to be completely autonomous in making a decision about abortion and not only in her first third. For example, in cases of long periods of pregnancy, according to the “Instruction on the procedure for the resolution of the operation of artificial termination of pregnancy on non-medical indications” in 1988, non-medical grounds for the termination of pregnancy at the request of a woman are – “death of a husband during pregnancy, the presence of a woman or her husband in places of deprivation of liberty, deprivation of the rights of motherhood, large families (the number of children over five), divorce during pregnancy, disability of the child. If the woman has grounds not provided in this instructions, the issue of abortion is decided by the Commission (medical institution) on an individual basis.” And if, as a rule, such operations are quite expensive, there are such medical organizations that carry out abortions only with a long period of pregnancy and absolutely free. These are medical research institutions using embryonic material of late pregnancy (18-22 weeks) for fetal therapy.
God’s essential, internal freedom of man can hardly be unconditionally and definitively limited by any external, in this case power, factors, including state legislation. The failure of the legal prohibition and restriction of this freedom (in case of termination of pregnancy), even under pain of severe punishment, is just another proof of this. The only person who can limit his essential freedom is the person himself. One of the interpretations of sin is connected with the understanding of sin “not as disobedience, but as loss of freedom”. A woman who makes an abortion loses her freedom, loses the gift of being a mother. And whatever “testimonies” accompany this loss, it is in the Christian tradition a manifestation of social and moral evil.
Without sharing the ideas of traditional morality, the liberal consciousness builds its argument of “morality of abortion.” The starting point in this argument is the principle: “the right of a woman to abortion.” An analysis of this judgment reveals that it had its meaning more in the context of the struggle between liberalism and conservative legislation that pursues the production of abortion than under the rule of liberal legislation that permits the production of abortions. In this situation, the principle of “women’s right to abortion” as a “value” of the struggle loses its positive meaning. Therefore, in the arsenal of liberal ideology appears the principle of “the right of women to their own body,” or “the right of women to dispose of the function of their body.” But without a specific medical content, the use of this judgment is hardly advisable. It is known that the metaphysical basis of the liberal consciousness is naturalistic-materialistic anthropology. According to the latter, a person is a “psychomaterial body”, “self-aware matter,” and even “the body and only the body” (F. Nietzsche). On the other hand, abortionists argue that the germ of the human being is virtually nothing of itself, except for the “clot of tissues” or the “bloody mass”. In the light of what has been said, the proposition “the right of a woman to abortion” becomes a judgment “the right of the body to own body” or “the right of the body to dispose of the function of its body.” Can such a judgment serve as a regulatory standard or value?
“Denial of the personal status of the fetus” is the second fundamental principle of abortion advocates. Indeed, if we proceed from the understanding of morality as a system of ideas regulating relations between people, then it is necessary, at least formally, the existence of two subjects of this relationship – “man-man.” If we assume that the fetus is not a human being, then, because of the absence of the second subject of a moral attitude, abortion is not a moral problem at all. The adoption of a decision on abortion is the result of the calculation of certain interests, the balance of life circumstances, but in no case it is a moral act. But is it possible to assume that the fetus is only a “clot of tissues” and not a human being?
THE PROBLEM OF EMBRYO STATUS
The human being, when developing, passes a series of stages – from the fertilized cell to the individual. At what point does life begin at these stages? Is it possible to put an equal sign between the concepts – “man”, “embryo,” “oocyte,” “germ”? At what point does a human being become a moral subject? The concrete answers given by culture and science changed from epoch to epoch.
According to the ancient Eastern tradition, the age of a person is counted from the moment of conception. In ancient Western civilization, it was widely believed that life begins with birth. For a long time, doctors linked the beginning of the life of the fetus with the first “stirring”. In the Catholic Church, since the late Middle Ages, thanks to the developments of Thomas Aquinas, the Aristotelian concept of “animation” (on the 40th day after conception in men and on the 80th – in women) worked.
The natural-scientific, or physiological, position relative to the “beginning” of human life differs from the religious (metaphysiological) fundamental lack of a unified solution even in the space and time of modern culture. Different physiological approaches can be combined only on a formal basis. The answer to the question: “When does human life begin?” always involves the reduction of the “beginning” of life to the “beginning” of the functioning of a particular physiological system – palpitation, pulmonary or cerebral activity. For example, at the beginning of the 20th century, biology linked “life” with a 4-month-old fetus, because “an embryo of up to six weeks is the simplest tissue, up to two and a half months is a mammalian being of lower order, and it is from four months that the appearance of the fetal brain tissue is fixed, which indicates the emergence of a reflexive-perceiving being”. At the end of the 20th century, a 6-week fetus recorded the electrophysiological activity of the brainstem. It is noteworthy that the disappearance of these brain impulses in humans is the modern legal basis for ascertaining his death. If we transfer the modern criterion of death of a person – “brain death” – to the level of the problem of determining the criterion of the beginning of life, then, keeping the logic, it is these 6 weeks – the beginning of brain stem activity – that must be accepted as the time of the beginning of life. But the fullness of brain activity is associated with consciousness and speech. One can not help but recall that consciousness and language, as signs of personality, appear only in the second year of the child’s life. But the recognition of this figure for the beginning of human life is absurd and, therefore, generally casts doubt on the option associated with the “brain” criterion.
Another distinguished physiological boundary of the origin of human life is the first heartbeat (4 weeks). At the same time, the formation of the pulmonary system (20 weeks) is of fundamental importance for many, which testifies to the “viability” of the fetus that has arisen. Viability means his ability to survive outside the mother’s body.
Recently, physiological boundaries are increasingly emerging at the cellular level. Modern microgenetics has two approaches. According to the first, the individual proper – a unique and indivisible integrity – is formed during the 2nd week after conception as a result of a complete loss of the ability of the parent cells to self-exist. Another position, common among microgenetics, connects the “beginning” of human life with the moment of fertilization of the egg as a moment of obtaining a complete and individual set of genes for the future biological organism. From the point of view of modern biology (genetics and embryology), the life of a person as a biological individual begins from the moment of the fusion of the nuclei of male and female sex cells and the formation of a single nucleus containing unique genetic material.
Throughout intrauterine development, a new human body can not be considered part of the mother’s body. It can not be compared to the organ or parts of the organ of the mother’s body. Therefore, it is obvious that abortion at any term of pregnancy is a deliberate cessation of a person’s life as a biological individual.
Ethical knowledge offers its answers to questions about when and under what conditions a human being becomes a moral subject, i.e. the bearer of moral rights proper, and above all the right not to be put to death. Unfortunately, it is also not necessary to talk about unanimity of ethical approaches. According to one of them, the question of the beginning of the life of a human being can be solved on condition that the criterion for the moral status of the human fetus is determined. Rationality, the ability to reflect, to act, to conclude a contract and other similar criteria of a moral subject, the person disappears, since the speech is still about the fetus in the womb of the mother. Of the numerous studies of this problem, four more properties can be identified, which, according to general opinion, are able to fulfill the function of the criterion. It is internal value, vitality, rationality, reaction to irritants. As a result of a critical analysis of each of them, scientists come to the conclusion that in the course of applying them to the situation of moral choice in abortion, “the only criterion is the criterion for responding to stimuli, understood in the narrow sense as the ability to feel pleasure and pain, pleasant and unpleasant”. This criterion is chosen as the basis for “the ability to establish a significant difference in morality between the early and late termination of pregnancy… This is the second trimester of pregnancy (3-6 months).” The coincidence of this approach with everyday ideas, with legal practice makes the early termination of pregnancy morally admissible.
Nevertheless, from our point of view, such an approach can hardly be assessed as impeccable. The moral status of a human being is not determined by a set of physiological reactions and properties. This “definition” is akin to what is already known: the procedure of reducing the moral, ethical to the biological, with the good, but not quite correct purpose of explaining moral values and norms. If we are talking about the moral status of the fetus, trying to answer the question of the morality of abortion, then it is best to do this, being within the limits of the moral consciousness itself, and not physiological procedures. Under these conditions, the fetus acquires a moral status, participating in a moral relationship. The criterion for the moral status of the fetus is its inclusion in the moral attitude that arises when a fetus, an embryo, an embryo, a “clot of tissue” becomes an object of moral reflection for the mother, at one or another critical moment of choice, and for human culture, the problem of the moral status of the embryo already makes it a subject of fundamental moral rights, while demonstrating the moral qualities of the human race as a whole, such as solidarity, duty, mutual responsibility, freedom, love, charity.
It is hardly reasonable to deny these values, which are the traditional content of the moral and ethical “due”, despite the reality of various everyday circumstances, different practical interests, and all the situational diversity of “being.” The moral and ethical solution of the problem of the beginning of human life (in its nonreductionist form) is a reasonable and consistent addition to both the religious position and the natural science, presented by studies of modern microgenetics, and performs one of its traditional functions of life-protection.
CONSERVATIVE FORECASTS AND ESTIMATES
The ideal of absolute goodness in terrestrial conditions is unattainable, and new forms of social life that will be able to work out for future generations will bring only partial improvements to some aspects of existence, and, at the same time, they may breed some new manifestations of evil. We can already see these trends.
One of them is recorded by E. Durkheim in his fundamental sociological study of nature and the reasons for the increase in the number of suicides in modern culture: “So the facts do not confirm the common opinion that suicides are caused mainly by the burdens of life, on the contrary, their number decreases as the existence becomes worse.” Here is the unexpected consequence of Maltusianism, which his author certainly did not envision. When Malthus recommended abstinence from procreation, he thought that at least in certain cases this restriction is necessary for the common good, in fact, it turns out that abstinence is such a strong evil that it kills the very desire to live in a man. Large families are not at all a luxury which only rich can afford; essential bread, without which you can not live”.
The second trend was in the form of a “sexual revolution”, which European civilization has been experiencing since the mid-20th century. H. Hefner, the founder of Playboy magazine, analyzing the causes of the sexual revolution of the twentieth century, speaks of three main factors: the emergence of contraceptives, antibiotics and free money. It is impossible not to add to these factors the fundamental changes in the moral and ethical consciousness, which psychoanalytic medicine and psychology contributed to. It consisted in a principled division of sexuality proper (as a manifestation of the libido) and the function of procreation. Contraception as a means of suppressing this function becomes a symbol of liberated sexuality.
It is not surprising that between Orthodox scholars there is universal agreement on the following two points:
- Because one of the purposes of marriage is the birth of a child, the couple is immoral, constantly resorting to methods of contraception in order to avoid this, if there are no mitigating circumstances for that;
- Contraception is immoral even when it promotes fornication and adultery.
This categorical has its reasons. Orthodox authors disclose that the unconditional use and mass distribution of contraception is the moral emasculation and depreciation of man. The understanding of sexual love as one of the forms of the possible spiritual perfection of husband and wife in love and unity allows “the use of contraceptives for the purpose of delaying the birth of children and limiting their number in order to give greater freedom to the couple for the manifestation of their mutual love”.
Because of the opposite orientation of the values of the conservative and liberal position, the Catholic Church “absolutely prohibits sterilization, as a means, irreversibly impeding procreation”. It is obvious that it is also unacceptable for Orthodox traditions.
The Christian Church, both Orthodox and Catholic, are social organizations that unite people, in fact, in all regions of the world. Nevertheless, it unreservedly gives priority to the individual choice of the couple of their reproductive rights, condemning any measures of organizational control under the sign of any “good” idea, whether it is the “healing of the nation” or “the welfare of mankind”.
ABORTIONS: TO BE OR NOT TO BE?
A woman, like every living person on this planet, has every right to dispose of her body, since it is given to her by nature. An embryo, like the part of a woman’s living body that forms after sexual intercourse, belongs exclusively to a woman. If she believes that, given the financial, family and other circumstances, the child should not be born, then she has every right to interrupt pregnancy by artificial means.
When the opponents of abortion claim that the woman is the continuer of the human race and abortion creates demographic problems, then it involuntarily gives the impression that the woman is perceived as a living incubator without the right to choose. Indeed, every state administration deals with issues of biological power, when the level of births or deaths is controlled, the rate of reproduction of the population.
In economically and culturally developed countries, this happens with the help of “soft” mechanisms: social benefits for young families, propaganda in the mass media, improvement of educational institutions of preschool age. Attempts to tighten legislation by restricting the rights of female citizens to meet certain demographic problems are at least undemocratic.
The church is trying to introduce radical initiatives (permission to open religious schools, the church’s exemption from taxes) into the legislative process. Thus, it tries to demonstrate influence on the institutions of state power, obtain financial privileges and legalize religious ideas in society with the aim of further legitimizing it in society.
Today, we can face the problem that now exists even in civil countries, when the church plays such a significant role in the system of state power, which leads to absurd in essence criminal precedents against citizens.
DOES THE WOMAN HAVE THE RIGHT TO ABORTION? AMERICAN PRACTICE
When the interruption of pregnancy occurs naturally, it is called spontaneous abortion or miscarriage. If, for a woman, immaturity is undesirable, she sometimes tries to find a way to interrupt it, perform an artificial abortion. According to statistics in the United States of America, about one and a half million women every year make abortions – one in three pregnant women.
As evidenced by the existing trends, the ratio of the number of abortions to the number of pods in the last time has decreased. This is due to the fact that young women in the age of up to fifteen years are much less likely to choose a variant with abortion than before. Recent data show that from eighty to ninety percent of people call abortion admissible in certain circumstances, and 33 percent believe that abortion should be allowed for any reason. Only fifteen percent of Americans believe that abortions must be forbidden in all cases.
The position of opponents of abortion. Many disputes of the political and ethical nature of the above-mentioned problems of abortion begin with a question of the origins of human life. A lot of proponents of abortion believe that life originates at the time of conception and abortion is equivalent to murder, as the life of a person is interrupted. In this regard, some exterminated citizens believe that the explosions or burning of hospitals where they perform abortions, and even the death of the doctors involved in this, must be juridically corrected.
Meanwhile, legal supporters of abortion, for the most part, believe that abortion provides the right of women to make their choice in conditions of overpopulation of the world, when in many families parents simply are not able to take care of their children. Supporters of abortion think more about what the life of a child who has not yet been born will be.
There is in the arsenal of abortionists the argument about the right of a woman to dispose of her body, not excluding the right to interrupt the pregnancy or save a child. Even the Supreme Court of the USA once had to engage in a struggle with protracted polemic.
Roy against Wade. In 1978, a historical decision was made regarding the case of Roy against Wade, when a woman was sealed with the right to perform abortion of a qualified doctor. With his latest decisions, the Court has secured this right, has given the states the right to legislate with respect to abortion, with the opinion of the majority of the people in the state. For example, state laws have been adopted that prevent certain workers in the medical sphere from submitting information about abortions. There were laws that demand to inform husbands (or in case of unsuccessful birth of a woman-parents) about a woman’s desire to have an abortion. However, the procedure for getting rid of pregnancy did not become more humane.
A WOMAN, NOT A CHURCH, MUST DECIDE WHETHER TO HAVE AN ABORTION OR NOT
It is time for us to depart from the medieval concepts. After all, the birth of a child is not the woman’s responsibility, but her right. From time to time, all countries come across the same problem of church interruption into legislative activity. Leaving aside the question why in the modern secular country, where the church is separated from the state, the “council of churches” (what, by the way, is the status of this organization?) interferes with the constitutional process, let’s try to consider the amendments in fact.
One of the most radical proposals of churchmen is the prohibition of abortion and euthanasia. And this, from my point of view, is the leader in the hit-parade of delusions on optimizing the Constitution. It was not easy to deserve this title, but the church tried. There is one elementary rule applied in all spheres of life. It can be stumbled upon in any law, it is one of the main principles of doing business and one of the pillars of public morality. It sounds like this: “Responsibility is borne by the performer”.
And according to this rule, only a woman, not a society, not a husband, not a law and not even any special women’s council, but only every single woman can decide whether to have an abortion or not. This is a question that does not concern anyone other than her. Men screaming “I will not let my woman do an abortion” are not much different from bastards making their girlfriends get rid of a potential child against their will. It is not for nine months that they will be sick every morning, they will not get tired of walking to the inability to walk, and they will not loosen their loins every evening, they will not push themselves to the rupture of the perineum, and then feed the newborn with their own body for another year. And this I’m not talking about violations, pathologies and other problems of pregnancy and childbirth. I’m not talking about cases of rape followed by pregnancy. About women who can hardly feed themselves.
This is only their decision; every particular woman decides for herself.
In Poland, abortion at the request of a woman is prohibited. Abortion is allowed in exceptional cases – for medical reasons, when pregnancy threatens the physical or mental health of a woman, if there are abnormalities of fetus development or in case of conception occurred during rape. “I can say one thing – if a woman decides to have an abortion, she will travel to the Czech Republic and make it there. And it turns out that the only victims of this ban are young girls who for one reason or another have become pregnant, and they do not have the money to travel to the Czech Republic. And then only three options are left – illegal abortion, orphanage, or crippled life with an unwanted child behind all the poverty lines. But no one asks! Because in the debate about abortions, we have old men who “do not care” and rich ladies who can afford to give birth and bring up,” say Polish ladies.
The question, in fact, is not whether to ban or not – such a question should not be asked at all. The prohibition of abortion is barbarism and the Middle Ages. The correct question is whether to do it or not. The question is complex and extremely individual. It lies in the plane of morality, psychology and security. And every woman has her own answer.
For myself, I decided long ago that I will not do abortions – even with a very sudden and inappropriate pregnancy. The only exception is medical indications. But I made this decision myself. And I can not blame women, whose decision is different from mine. It is time for us to depart from the medieval concepts. After all, the birth of a child is not the woman’s responsibility, but her right.
ABORTIONS: HOW DIFFERENT COUNTRIES SOLVE THE MOST CONTENTIOUS PROBLEM
In October 2015, experts from the Pew Research Center published a study of Worldwide Abortion Policies, which analyzed the legislative status of artificial abortion in 196 countries around the world. Analysis of the UN data showed that in almost all countries (96%) abortions are allowed if there is a threat to the life of a woman. However, six countries – Chile, the Dominican Republic, El Salvador, Nicaragua, the Vatican and Malta – prohibit abortion, regardless of the circumstances.
In 50 countries, which is 26% of the total number, the only legal basis for the artificial termination of pregnancy is the existence of a threat to the life of the mother. In addition, in 82 countries (42%), abortions are permitted in a number of other cases: for example, to preserve the physical and mental health of women if pregnancy is caused by rape or incest, as well as for socio-economic reasons. The remaining 58 countries (28%) allow abortion for any reason (but in many of these countries, the artificial termination of pregnancy is prohibited after a certain period).
However, according to a recent study by the World Health Organization (WHO) and the American Institute of Guttmacher, the criminalization of abortions does not help to reduce their number. Thus, in countries where abortion is prohibited or permitted only to save the life of a woman, 37 such operations are performed per 1000 women of reproductive age, while in countries where abortions are permitted – 34. According to scientists, it is much more rational “to invest in modern methods of contraception than to prohibit abortion at the legislative level.
In general, according to the study, the annual number of abortions in the world increased from 50.4 million in 1990-1994 to 56.3 million in 2010-2014. At the same time, growth was observed mainly in developing countries (from 38.6 million in 1990-1994 to 49.6 million in 2010-2014). During the same period, the number of abortions in developed countries decreased from 11.8 million to 6.7 million per year. The largest number of abortions in 2010-2014 was done in the Caribbean: 65 per 1,000 women of reproductive age per year. Next come the states of South America, where 47 abortions per 1000 women were done every year. At the same time, the lowest number of artificial abortions was in North America, and also in Western and Northern Europe (17 and 18 abortions per 1000 women of reproductive age, respectively).
Despite the fact that the number of abortions in Latin America and the Caribbean increased by almost 50% over the period under study, the results of the Pew Research Center study in 2014 show that the society in this region mostly opposes the legality of abortions. The exception was Uruguay: here 54% of citizens believe that an artificial termination of pregnancy should be allowed in all or in most cases. It is worth noting that Uruguay became the second after Cuba’s Latin American country, which allowed abortion for all women.
Meanwhile, the opposite situation is observed in the USA. As Reed wrote, 56% of Americans believe that abortion should be legal in all or in most cases. In the last decade, the number of abortions in the country has gradually decreased: in 1996 – 1.36 million, in 2011 – 1.06 million, in 2014 – 977 thousand.
In Europe, the only country (not counting the Vatican), where abortions are completely banned, is Malta. For conducting an operation on artificial termination of pregnancy, doctors face from one and a half to four years of imprisonment and a lifetime ban on the profession, and women who have undergone abortion – from one and a half to three years in prison. Not being able to have an abortion inside the country, women go abroad for an operation: on average 54 abortions are made outside Malta every year (that is, 11.5 abortions per 1,000 live births). The authorities oppose any indulgence in the law on abortion, referring to a similar opinion of 60% of the country’s population.
According to journalist Valerie Gore, who prepared a report on abortion in Malta for Euronews, the island state is one of the leaders among European countries in terms of the number of congenital malformations of the fetus. In addition to Malta, the top 3 also includes Ireland and Poland – countries with strict legislation on abortion. Thus, in Ireland, abortions were partially permitted (in the presence of a threat to the life of a woman) only in 2013. In Poland, abortion is allowed in three cases: if continuation of pregnancy can pose a threat to the life or health of a woman, if the pregnancy occurred as a result of rape or incest, or if the fetus has serious malformations. At the same time, opponents of abortion demand to prohibit the artificial termination of pregnancy, except for cases when the life of a woman is under threat.
Brazilian activists also demanded the legal termination of pregnancy, but so far their appeals have not been crowned with success. In Brazil, abortion is prohibited unless the life of a woman is at risk, if the pregnancy has occurred as a result of rape, or in the case of anencephaly, a developmental fetus that lacks parts of the brain or skull. However, local authorities, on the contrary, offered to tighten legislation in the sphere of abortion. According to a bill drafted by one of the conservative parliamentarians, the maximum term of imprisonment for women who have undergone abortion should be increased from three to four and a half years, and for doctors performing the operation, from four to six.
After an unwanted pregnancy is confirmed, a woman needs to realize her new condition and make a decision. She should know that abortion is not the only way out: you can give birth to a child and give it up for adoption; finally, you can save your pregnancy and raise a child. Helping a woman with advice, a counselor should take into account her religious beliefs, life values, how free she is in choosing a decision to have an abortion and whether she is pressured by the child’s father, whether her family members or friends support her.
Another serious question that should be considered by a woman who has decided on abortion is the medical risk associated with this procedure. Complications after an abortion can be the following: infection, blood clot formation, incomplete tissue removal, continuation of pregnancy after an abortion has been made. Abortion can lead to damage to the uterine wall (perforation), bleeding, and disrupt the ability of the cervix to retain the fetus during subsequent pregnancy.
All this information can cause a woman fear, confusion, anger at the child’s father, a sense of guilt and longing. For a man, this situation is also unpleasant. It happens that he does not mind having a child, but he was not even consulted about abortion. He can feel guilty because he caused the woman a grief, or because he dumped it, as soon as he learned about the pregnancy. Both partners should be able to get professional advice, but, first of all, they need to frankly discuss this problem among themselves. Only in this case, you can make the right decision.
Sexual intercourse is an expression of sexuality that brings partners the greatest satisfaction. However, it is usually associated with the danger of unwanted pregnancy. Conception can be prevented with the help of contraceptives or by resorting to natural ways of family planning, abstinence or surgical sterilization. Currently, contraceptives use condoms, birth control pills, intrauterine devices, vaginal spermicides, contraceptive sponges, diaphragms and cervical caps. Other types of contraception are being developed and are being tested. Some couples practice interrupting sexual intercourse before ejaculation. Sterilization, or surgical operation on the reproductive system, can be carried out both in women and men. Sterilization is the most effective method of contraception.
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