There is nothing unusual about Irish women travelling to the UK for abortions. Abortion is illegal in Ireland and as a result it is estimated that 7000 women travel to the UK each year to have abortions. This week's story of Ms D, however, is different.
Ms D is seventeen years old. She has an alcoholic mother, an absent father and is under the care of the HSE (Health Service Executive). On discovering that she was pregnant, she did want to continue with the pregnancy. However, she was recently told that her baby would be born with anencephaly (part of the brain, scalp and skull missing), a condition that would almost certainly result in the baby's death within three days of birth. This information has made her decide that a termination is best. She is, however, being prevented from travelling to the UK for the abortion and the HSE has even sought the help of the Gardai (Irish Police force) to prevent her from doing so. But is her case really a debate about abortion?
Ms D's case is a good example of the impact of religion on law. Ireland is a largely Catholic country and, in keeping with Catholic beliefs, abortion is outlawed. What role religion ought to play in law, as well as the relationship between religion and medical ethics is both interesting and controversial but not of particular relevance to the current discussion.
The debate about abortion splits roughly into two camps, one that believes in the preservation of life and the other that believes in the preservation of choice. The latter is often misunderstood as being pro death or pro abortion, whereas it is, in fact, just pro choice, i.e., it supports the right to choose a termination should a woman want one rather than supports the position that a termination is always the right choice. Other elements of the abortion debate ask whether life begins at conception or at birth, when a foetus becomes a person and so on. To classify Ms D's case as one of abortion would be to claim that one or more of these issues pertains to her; we would be hard pressed to show that this is so.
The controversy surrounding Ms D's case does not strive to define life or personhood. The sad fact of Ms D's case is that her baby is going to die and, to that extent, this is not a case about the moral permissibility of abortion. To argue the moral issues surrounding abortion presupposes that there actually is a choice as to whether or not to preserve life. Ms D's baby is not going to live so the preservation of life is not an issue. The real question is whether or not it is morally permissible to force Ms D to carry a foetus to full term when we know that the baby will die within three days of being born.
This question may seem the same as one that asks whether it is morally permissible for her to have an abortion but there is a subtle, yet significant difference between the two questions.
The first question focuses on whether a life that cannot be preserved ought to be prolonged for what is of no benefit to either baby or mother; the second question asks whether it is morally permissible to terminate a life that could otherwise be preserved. I have already explained that as the baby's life cannot be preserved, the second question is not relevant to the case.
Of course it is true that not prolonging the life of Ms D's baby can only be achieved via an abortion but it is still not abortion which is the focus of the moral debate. Abortion is only a means of not prolonging the life of the foetus. Both performing and not performing the abortion will ultimately result in the same outcome. The only difference is in timing. Performing the abortion will result in the death of the foetus at the time of the termination whereas not performing it will result in the death of the baby shortly after birth.
There seems to be no moral reason that focuses on benefit to mother or baby to avoid a termination. The mother, who already has numerous family problems and is now grappling with the problems associated with an unhealthy foetus is unlikely to benefit by carrying the foetus to term, giving birth and then having the baby die three days later. In fact, she is likely not just to "not benefit" but also to be harmed by carrying the foetus to term. The psychological strain of continuing with a pregnancy that will ultimately result in the death of the foetus ought not to be underestimated and is, arguably, worse for her than the termination that she has requested. Considering that Ms D is under the care of the HSE, it is surprising that the HSE is proposing a course of action that is likely to result in both physical and mental distress to Ms D. The termination of a foetus who is almost certain to die within three days of being born is unlikely to be greater than the physical and mental anguish of continuing with the pregnancy, giving birth and then having the baby die, particularly since a termination is what Ms D wants.
Ms D's case may appear to pull abortion, religion and medical ethics together but on a closer examination of the issues we find that this is not so. Abortion is secondary to the central moral question of whether it is right to prolong life unnecessarily. To confine our moral discussion to abortion is to overlook this central moral question.
This article neither supports abortion nor argues against it. It merely points out that the case in question is not really a moral debate about abortion. Unlike most cases of abortion, where the decision is between terminating a pregnancy that would otherwise result in a baby that would live and not carrying out the termination, in this case, the baby will die regardless of what is done. The choice is merely whether to perform the termination and let him or her die in the womb or bring the foetus to full term and let the baby die shortly after birth.
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Since this article was written, the courts have ruled in favour of Ms D and have granted her permission to travel to the UK for the termination. This decision was based on the argument that to prevent her from doing so would amount to "degrading treatment." It has also been argued that the real issue is not abortion but choice. Ms D has the choice to travel to a country where abortion is legal which, in effect, means that she is choosing to have an abortion. This choice is one that is discussed above. Once again, it is important to bear in mind that regardless of one's views on abortion, the central moral question is whether a life that is bound to end as soon as it begins ought to be preserved or whether we can avoid prolonging life unnecessarily. To discuss Ms D's case in terms of abortion alone is to ignore the main moral issue.
11 May 2007