A moral theory's immoral outcome

Is it always wrong to take an innocent human life? Many philosophical defenders of the Roman Catholic natural-law tradition argue that there are no exceptions to this prohibition, at least if we are talking about taking the life intentionally, and directly, rather than as a side effect of some other action. (These moral theorists also define “innocent” to exclude enemy combatants, as long as the war one is fighting is just.)

When this view is combined ­— as it typically is in Catholic teaching — with the claim that every offspring of human parents is a living human being from the moment of conception, the implication is that abortion is never permissible. But the case of a 22-year-old El Salvadorian woman, identified in the media only as Beatriz, makes the absoluteness of that view very difficult to defend.

Beatriz, the mother of a young son, suffers from lupus, an autoimmune disease, and other complications. Her first pregnancy was very difficult. Then she became pregnant again, and her doctors said that the longer the pregnancy continued, the greater the risk that it would kill her.

For most women, that alone would be sufficient grounds to terminate the pregnancy. But Beatriz had an additional reason to do so: the fetus had anencephaly, a condition in which the cerebral cortex, the part of the brain associated with consciousness, is absent.

Almost all babies with this condition die soon after birth; the few survivors are incapable of responding even to their mother’s smile.

While traditionally Roman Catholic European countries like Italy and Spain have liberalised their abortion laws, Latin America has remained true to the faith, maintaining some of the world’s strictest legal prohibitions. In El Salvador, abortion is prohibited without exception. In April, Beatriz’s doctors asked the courts to allow them to terminate her pregnancy on medical grounds, but were refused. On May 29, the Supreme Court denied Beatriz’s appeal.

To anyone concerned about human well-being — or, for that matter, human flourishing in general — such an outcome makes no sense. Aborting an anencephalic fetus ends a life that may be human, insofar as it is the life of a member of the species Homo sapiens; but it is a life that will have zero well-being, for the infant (if it lives) will be incapable of enjoying anything.

On the other hand, not permitting Beatriz to have an abortion would risk causing the death of a young woman who desperately wanted to live, and had much to live for. It would also risk depriving her one-year-old son of his mother.

After the Supreme Court’s decision, El Salvador’s health minister, Maria Rodriguez, announced that Beatriz would be permitted to undergo a “premature Caesarean section,” which she said was not an abortion, but an “induced birth.” That procedure was carried out on June 3; the anencephalic newborn died five hours later.

If that was supposed to be a better outcome than an earlier termination of the pregnancy, it is hard to see for whom it was better. It was certainly not better for Beatriz, who is still in intensive care, and for whom the long-term health impact of the pregnancy remains unclear. And how did it benefit the infant to have another couple of months of life in utero, and then five hours of life outside?

One point overlooked in the discussion of Beatriz’s case is that the same Catholic natural-law theory that insists that killing an innocent human being is always wrong also provides a basis for arguing that it is not wrong to kill an anencephalic fetus. In innumerable texts, Catholic philosophers, theologians, and bioethicists argue that it is always wrong to kill innocent human beings, because, in contrast to nonhuman animals, they have a “rational nature.” Proponents of this argument use that term to include beings that are not yet capable of rationality but will become so in the normal course of their development.

The use of the term “being with a rational nature” is very broad, perhaps too broad even when applied to normal fetuses. To apply it to anencephalic fetuses requires a further, and much more dubious, step.

Thomas Aquinas, for instance, did not think that a rational nature is present in every member of the species Homo sapiens. He believed that some degree of development is necessary for the human animal to become a being with a rational nature. In the case of an anencephalic fetus, no such development is possible. It cannot become a rational being.

For that reason, even those who believe that it is always wrong intentionally to kill an innocent being with a rational nature should not have opposed permitting Beatriz to terminate her pregnancy. They should have embraced a humane solution that minimised the risk of a tragic ending to a story that was already sad enough.

Copyright: Project Syndicate, 2013.

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Peter Singer is Professor of Bioethics at Princeton University and Laureate Professor at the University of Melbourne. His books include Practical Ethics and Rethinking Life and Death.