Abortion wars in Canada

Here's is this last week's column from the Kingston Whig-Standard.

One of the reasons for Stephen Harper’s past electoral successes had undoubtedly to do with his promise not to touch the abortion or the marriage equality issues while in office. Canadians are not keen on reopening, in particular, the divisive abortion controversy. Realizing that any other course of action would be politically suicidal, Harper has slapped down backbenchers of his own caucus who tried to do otherwise. One has to give credit to the man where credit is due, whether because of political expediency or because he takes promises seriously, the prime minister stuck to his guns on the abortion issue.

Let me say at the outset that I support the status quo on abortion in the country. It’s up to pregnant women to decide whether they have an abortion or whether they carry a pregnancy to term. There are good moral reasons to do with what I take to be the moral status of embryos and fetuses and what I take to be the moral foundations of what is a woman’s absolute right to control what is happening to her body. This is well-trodded ground, though. These arguments have been going back and forth between pro-choicers and anti-choicers at least since the late 1960s. I am not going to bore you with a rehash of these arguments. Those who disagree will continue to disagree. If you believe that an embryo is a person from the moment of conception, nothing that I can say with regard to the science and morals of what dispositional capacities should be required to call something a person will likely sway you toward my take on the issue.

I am more concerned about patterns of what I take to be strategically motivated campaigning by anti-choice groups. I first noticed it in the context of the euthanasia debates. Anti-choice activists, typically closely aligned with conservative religious organizations such as the Roman Catholic Church, have started repackaging their campaign messaging. In the good old days, they’d have simply told us that their God doesn’t like euthanasia and then they would have expected the rest of us to fall in line. That, of course, doesn’t quite cut it any longer today. So they have started resorting to quite vacuous rhetoric such as that euthanasia violates “human dignity.” When you ask what exactly they’re talking about here, Christian ideology comes to the fore in no time. It’s really just an attempt to sell religious views in secular verbiage. Or they claim that “vulnerable” people would be at gravest risk of abuse. A closer look at the social class makeup and educational background of the vast majority who ask for assistance in dying shows that there’s nothing to this scare campaign, either. Call me a cynic, but I am not just a little bit suspicious that this rhetoric is truly mere expediency. It has probably been road tested with pilot groups and has yielded results considered desirable by these same religious campaign organizations.

I cannot help but wonder whether a similar switch has also occurred in the abortion wars. Knowing that the overwhelming majority of Canadians are perfectly comfortable with where we are at with regard to the legal status of abortion, activists have been looking for wedge issues, that is issues where even your average liberal Canadian would scratch their heads wondering whether that might not be problematic. The objective here is to build coalitions with people who would generally consider themselves pro-choice or “on the fence.” What’s needed, much like in the euthanasia debate, are sensitive issues that would make people second-guess their stance on abortion.

And so it goes. The wedge issue chosen — strangely to my mind — isn’t late-term abortion. They typically do not occur for any frivolous or no reason at all, but because of very serious fetal abnormalities that were not caught earlier during pregnancy. While that is so, late-term abortions have been a popular target for anti-choice activism in the United States and elsewhere. Their Canadian brethren have instead zoomed in on sex selection. You know, women having abortions because of the sex of the fetus. I could be mistaken, but it seems it all started with what I still consider a remarkably disingenuous editorial penned by an interim editor of the Canadian Medical Association Journal about two years ago. He suggested that pregnant women should not be provided with information about the sex of their fetus in order to prevent sex-selective abortion among Indo-Canadians. In the editorial, he refers to female fetuses as “girls.” Incredibly, he even referred to “saving” millions of women in India and China, as if the abortion of female fetuses amounted to the murder of either girls or women. It tells you a lot about the Canadian Medical Association Journal that such nonsense should ever have found its way into its editorial pages. There is, in fact, some weak evidence suggesting a slight gender imbalance among newborns of Canadians of East Asian descent, if a report published in the Toronto Star newspaper can be trusted. In the big swing of things, in Canada, this truly is neither here nor there. We must ensure that women are not pressured into having abortions, but ultimately, their motives are irrelevant, for all intent and purposes. We cannot say that women have the right to choose unless we disagree with their motives.

I have had gay friends of mine — happily pro-choice otherwise — who got all agitated when I suggested that at some point down the track, if we had a prenatal test for sexual orientation, some women might choose to abort fetuses testing positive for future homosexuality. They suddenly thought there should be limits on women’s rights to choose. Hello … conservative Christian campaigners, there’s a whole new target group for your material, a new partner in arms so to speak, gays concerned about their future numbers — who would have thought.

Conservative MPs and anti-choice campaigners decided opportunistically to ride this wave, complaining about “female gendercide,” pretending that this is a human rights issue. Of course, this can only be a human rights issue if you already assume that fetuses somehow have sufficient moral standing to grant them human rights. This isn’t actually the case in Canada.

It would be nice if political campaigners were more transparent about their motives. Anti-choice activists have truly refined their campaign techniques with a view to generating empathy among the wider Canadian public. We shouldn’t fall for these tricks.

Udo Schuklenk holds the Ontario Research Chair in Bioethics and Public Policy at Queen’s University, he tweets @schuklenk.

On sex selective abortion - again

Unless you live under a rock some place in Canada you cannot have missed this year's instalment of the annual procession of anti-choice campaigners on Ottawa's Parliament Hill. Of course, Canadians overwhelmingly are happy with the country's liberal take on abortion. So, much like Christian conservatives fudge the euthanasia issue by pretending that it is about protecting the 'vulnerable', the same people are at it when it comes to re-opening the abortion issue. They claim concern for what they describe as 'female gendercide'. Of course, there is nothing in Canada approaching a female gendercide, but like the vulnerability rhetoric in the euthanasia debate, they hope to garner at least some support when they make it look like they are protecting women. The real question is whether or not you believe that women should have the right to choose an abortion. The Canadian answer has been for a long time that they do. Once that answer is given, there are no 'right' or 'wrong' motives in that context, because a woman could even have an abortion for no reason at all. It is completely up to her. End of story. The nonsense about female gendercide defies belief, but it fits into a change of religiously motivated anti-choice activists' agitprop. Like in the euthanasia debates they no longer wave just their religious books, they do present actually public reason based arguments. It turns out these reasons are flawed, but they serve the agitprop purpose they have been invented for.

I repost below a commentary I wrote in January 2012 on this issue. Nothing really needs to be added, but it's well worth keeping it in mind in the context of the current anti-choice activities in Ottawa.

Odd CMAJ Editorial

There is a big of an outcry in Canada over an Editorial by the current Interim Editor-in-Chief of the Canadian Medical Association Journal, Dr Rajendra Kale. Kale argues that pregnant women in Canada should not be provided with information about the sex of the fetus to avoid female feticide among Indo-Canadians. Kale proposes that women should only be told 30 weeks after conception to make it more difficult for them to have an abortion based on an arbitrary marker such as the sex of the fetus. Indeed, The Toronto Star newspaper reports that there is some empirical evidence suggesting a not insignificant gender balance in parts of the country: 'Though Canada does not collect statistics based on ethnicity at birth, population statistics show the country, now home to more than a million Indo-Canadians, has a skewed gender ratio. According to the 2006 census figures, nationally there are 932 girls to 1,000 boys under age 15 in the South Asian community, compared to 953 girls to 1,000 boys in the general population. The numbers in the South Asian community in the Toronto area are further skewed with 917 girls to 1,000 boys in the Toronto Central Metropolitan Area. Broken down further, it shows 904 girls to 1,000 boys in Mississauga, and 864 girls to 1,000 boys in Brampton.'

The gender imbalance itself is not really a great deal of concern in the country as a whole, the differential between the South Asian community and the general populations is a mere 20. Not exactly a dramatic figure. That doesn't mean that this differential is not higher in certain parts of eg Toronto, but in the big swing of things this isn't a dramatic situation. Baldev Mutta, a staff member in a Punjabi Community Health Centre notes in the Star that there is a preference among recent immigrants in favour of male off-spring. Women are reportedly threatened with divorce if they don't agree to to abort female fetuses.

It goes without saying that putting women under such pressures is unacceptable. It also seems, for most circumstances, bizarre to me that - recent migrant or not - anyone would have strong preferences for the sex of his or her off-spring. However, there can be at least some ethically unproblematic reasons, too. For instance, a family might have a preference for a 50:50 ratio among their off-spring and so decide to abort a male or female fetus in favour of a future child of the desired sex. Having knowledge of their off-springs sex sooner rather than later arguably is better overall, because the aborted fetus would be less advanced in its development. There could also be good health reasons for wanting to know, for instance in the case of sex linked genetic diseases.

My point is that it is unacceptable to view certain reasons for wanting an abortion acceptable and other reasons sufficiently dodgy that one chooses ('doctor knows best', it goes without saying!) which women will be told of the sex of their off-spring and which women must not be told. It is clear from the statistics quoted by Kale in his Editorial that the overwhelming majority of Indo-Canadians do not actually choose abortions based on the sex of their off-spring. Preventing them -and anyone else -for that matter from knowing the sex of their off-spring is plain offensive. No wonder that a woman from such a cultural background is quoted along these lines in the Toronto Star, “It’s upsetting, to be honest with you,” says Hussain, who worries Kale’s editorial will further push this kind of discrimination. “It’s a stereotype that brown people will abort a child who is not a boy.” 

I might be mistaken, but I suspect that Kale's real agenda is anti-choice to begin with. He confuses fetuses and 'girls' as well as fetuses and 'women' in his Editorial as this quote shows quite nicely, 'Postponing the transmission of such information is a small price to pay to save thousands of girls in Canada. Compared with the situation in India and China, the problem of female feticide in Canada is small, circumscribed and manageable. If Canada cannot control this repugnant practice, what hope do India and China have of saving millions of women?'

Of course, the lives of neither women nor girls are at stake here. The issue is whether or not pregnant women have a right to know the sex of their off-spring. In Canada they do. It's a good thing. Cultural biases need to be confronted where they occur, there mustn't be technical pseudo-solutions to them that infringe on hard-won individual liberties that women can rightly take for granted today in Canada. If the argument really is about the morality of abortion, Kale should have argued that case and should not have chosen to engage in skirmishing activities to do with Indo-Canadians.

Margaret Somerville in secular garb - in the Catholic Register

Good fun, Margaret Somerville, a McGill law professor is interviewed in the Catholic Register. The main objective of the article is to figure out her 'secular stance' on assisted dying. For good measure, and presumably to ascribe expertise to her in matters bioethics, the Catholic Register describes her as a bioethics professor, yet McGill only notes her law school and her medical school professorial appointments. I was not able to find any evidence of her holding currently a formal appointment as a bioethics professor at that university. 

Evidence has never been MsSomerville's strongest point. So, without any evidence to back up her claims she declares on the Catholic website, 'One of the things that's wrong with respect to Justice (Lynn) Smith's judgment (in Carter v. Attorney General of B.C.) is that she purports to review the use of euthanasia and physician-assisted suicide in the jurisdictions that have legalized it. She said there is no problem, there is no slippery slope. Well, that's simply not right factually.' 

It turns out, in our Report on end of life decision-making in Canada we reviewed the empirical evidence on the slippery slope matter and concluded that there is no evidence that assisted dying leads us down slippery slopes to unwanted killings. Of course, we reviewed evidence, Ms Somerville is in full preaching mode. 

Ms Somerville also declares that 'The biggest group who are against euthanasia are doctors, and certainly by far not all of them are Church people.' Things are more complicated. For instance, a survey of medical specialists in Quebec reported a strong majority of medical specialists in that province coming out in favour of decriminalizing assisted dying. 

Ms Somerville is also up to her old magic tricks when framing the issue at hand: 'The pro-euthanasia people are very keen on saying there's a societal consensus, that everyone wants this. Well yes, but you've got to make sure those surveys are properly done. If you say to somebody that someone is in terrible pain and they want euthanasia, should they be able to have it? You've got to choose between saying yes to euthanasia and saying no to pain and suffering relief. What you have to do is ask people, does someone have absolute rights to all possible pain management? And the answer is yes, absolutely.' [emphasis added]

This is a true Somerville classic. The choice is, of course, not between either pain relief or euthanasia. You want good palliative care and access to assisted dying for those who do not consider their lives worth living. It's not either euthanasia or palliative care. 

She is also against equal marriage rights, because 'of its impact on kids' rights.' It goes without saying that there is no evidence that kids brought up in same sex families are in any way worse off than those who are brought up in heterosexual families, or that their 'rights' are violated in any appreciable sense. But hey, Ms Somerville is concerned. Right. How about reading up on the evidence?  I understood this to be an important concept in law, but I might be mistaken. She also notes, incredibly, that as far as she knows, homosexuality is natural 'for some people'. You just got to love her! - It is not terribly surprising, perhaps, that Ms Somerville's views, these days, are not even accepted as expert advice by the courts. As far as I can tell (her McGill website, her Wikipedia entry), this 'bioethics professor' has no formal qualifications in either ethics or bioethics.

Odd CMAJ Editorial

There is a big of an outcry in Canada over an Editorial by the current Interim Editor-in-Chief of the Canadian Medical Association Journal, Dr Rajendra Kale. Kale argues that pregnant women in Canada should not be provided with information about the sex of the fetus to avoid female feticide among Indo-Canadians. Kale proposes that women should only be told 30 weeks after conception to make it more difficult for them to have an abortion based on an arbitrary marker such as the sex of the fetus. Indeed, The Toronto Star newspaper reports that there is some empirical evidence suggesting a not insignificant gender balance in parts of the country: 'Though Canada does not collect statistics based on ethnicity at birth, population statistics show the country, now home to more than a million Indo-Canadians, has a skewed gender ratio. According to the 2006 census figures, nationally there are 932 girls to 1,000 boys under age 15 in the South Asian community, compared to 953 girls to 1,000 boys in the general population. The numbers in the South Asian community in the Toronto area are further skewed with 917 girls to 1,000 boys in the Toronto Central Metropolitan Area. Broken down further, it shows 904 girls to 1,000 boys in Mississauga, and 864 girls to 1,000 boys in Brampton.'

The gender imbalance itself is not really a great deal of concern in the country as a whole, the differential between the South Asian community and the general populations is a mere 20. Not exactly a dramatic figure. That doesn't mean that this differential is not higher in certain parts of eg Toronto, but in the big swing of things this isn't a dramatic situation. Baldev Mutta, a staff member in a Punjabi Community Health Centre notes in the Star that there is a preference among recent immigrants in favour of male off-spring. Women are reportedly threatened with divorce if they don't agree to to abort female fetuses.

It goes without saying that putting women under such pressures is unacceptable. It also seems, for most circumstances, bizarre to me that - recent migrant or not - anyone would have strong preferences for the sex of his or her off-spring. However, there can be at least some ethically unproblematic reasons, too. For instance, a family might have a preference for a 50:50 ratio among their off-spring and so decide to abort a male or female fetus in favour of a future child of the desired sex. Having knowledge of their off-springs sex sooner rather than later arguably is better overall, because the aborted fetus would be less advanced in its development. There could also be good health reasons for wanting to know, for instance in the case of sex linked genetic diseases.

My point is that it is unacceptable to view certain reasons for wanting an abortion acceptable and other reasons sufficiently dodgy that one chooses ('doctor knows best', it goes without saying!) which women will be told of the sex of their off-spring and which women must not be told. It is clear from the statistics quoted by Kale in his Editorial that the overwhelming majority of Indo-Canadians do not actually choose abortions based on the sex of their off-spring. Preventing them -and anyone else -for that matter from knowing the sex of their off-spring is plain offensive. No wonder that a woman from such a cultural background is quoted along these lines in the Toronto Star, “It’s upsetting, to be honest with you,” says Hussain, who worries Kale’s editorial will further push this kind of discrimination. “It’s a stereotype that brown people will abort a child who is not a boy.”

I might be mistaken, but I suspect that Kale's real agenda is anti-choice to begin with. He confuses fetuses and 'girls' as well as fetuses and 'women' in his Editorial as this quote shows quite nicely, 'Postponing the transmission of such information is a small price to pay to save thousands of girls in Canada. Compared with the situation in India and China, the problem of female feticide in Canada is small, circumscribed and manageable. If Canada cannot control this repugnant practice, what hope do India and China have of saving millions of women?'

Of course, the lives of neither women nor girls are at stake here. The issue is whether or not pregnant women have a right to know the sex of their off-spring. In Canada they do. It's a good thing. Cultural biases need to be confronted where they occur, there mustn't be technical pseudo-solutions to them that infringe on hard-won individual liberties that women can rightly take for granted today in Canada. If the argument really is about the morality of abortion, Kale should have argued that case and should not have chosen to engage in skirmishing activities to do with Indo-Canadians.

On Moral Authority - in lieu of an Easter sermon

Interesting, now we know that the Roman Catholic Church hierarchy all the way up to its CEO, the Pope, has been busy protecting child sexual abusers the world all over (the Irish government report on the abuse in the country mentions that child sexual abuse in Catholic outfits reached endemic proportions with confirmed cases now exceeding 15,000). We also know that the current Pope thought nothing was problematic about bringing into the fold of the church a known holocaust denying bishop. The list goes on and on and on. If this wasn't the 'church' but some Islamic outfit, no doubt they would be under security services' surveillance, but hey, it's the 'church', so it's kinda different I presume.

Part of the church (any church's actually) rationale for interfering regularly with the democratic state's policy making has to do with its claim to possess special 'moral authority'. So the church has been ever since busy writing high-minded documents protecting the 'unborn' (aka taking away women's rights to control their own bodies for the duration of their pregnancy). The church also issues, in the age of AIDS no less, guidance prohibiting all means of modern birth control such as using the pill or condoms to prevent pregnancy or sexually transmitted illnesses. They tell dying people that these patients have no moral claim to determining how they end their lives, even though this obsession with earthly living should be non-existent, considering that eternal paradise that is supposedly awaiting the deceased. Then there's endless documents going on about homosexuality and how terrible this 'disorder' is, and last but by no means least the church issues guidance documents inventing ever more reasons for religious conscience based objections to the provision of particular professional services by its members (aka special societal treatment for its professional members). In retrospect it is surprising that the church has rarely, if ever, commented on that small matter of pedophilia. Presumably an oversight.

In any event, the Roman Catholic church went recently out of its way to recruit right-wing outliers of the Anglican church. These outliers are opposed to women priests as well as openly gay priests. The pope saw an opportunity to increase the reactionary contingent among his preaching staff by offering such Anglican outliers a job in his organisation. It should not surprise anyone that the CEO of the competing Anglican church saw an opportunity to get even. He said in an interview that the Irish Catholic church had lost 'all credibility' over its handling of the child abuse scandal. He is right, of course, the Irish Catholic church lost indeed all credibility, as has the rest of the worldwide church. Being the Archbishop of Canterbury he then quickly recanted a day later, saying that he regretted his comments (but not withdrawing them).

What puzzles me is the proposition that the Roman Catholic church (or any other church for that matter) has special moral authority at all. I can see that it would have some authority over folks subscribing to its ideology. After all, if you're Catholic and your church offers a baseline normative guidance that it considers binding for its members, that surely is fair game. It's a bit like being voluntarily a member of the Communist party and embracing capitalism. Doesn't really work. The thing is though, that routinely you see its colourfully dressed senior staff come out in public telling all of us what we must and must not do, regardless of whether we have chosen to join their ranks. In other words, it uses its claimed moral authority to influence how people who do not subscribe to its views should live (indeed, even how they should die). And, interestingly, it is reported in the mass media as if there was any moral competence that these preaching guys have. This truly reminds me of the naked emperor case, except this time they're wearing dresses. The nakedness that we ought to call to the public's attention is that they do not have any moral authority at all in secular, multi-cultural societies. So, if they think that the 'unborn' is of infinite value and that abortions are always wrong they got to argue their case beyond their ideological base (aka believers). Their senior management staff happily use words such as 'genocide' and 'holocaust' in the context of abortion, presumably to make clear how 'wrong' abortion really is. Of course, this ain't answer the question of what it is that is wrong, ethically, about abortion - if anything.

It is insufficient for them to come out and quote the pope or any of their church documents that are relying on their religious scripture when they try to influence public policy. This is so, because too many people just don't buy into the biblical fairy tales. Now, it's perfectly possible that there are other, non-biblical reasons for why abortion might be ethically problematic, but these need to be explicated and defended.

What this boils down to is this: Religious folks must engage in proper ethical analysis and argument just like everyone else who wishes to make an ethical argument in public discourse. No matter how much they would like us to believe that raising their arms to the sky, wearing dresses and saying 'God' is somehow sufficient to claim moral authority, it clearly won't do in lieu of a proper argument. The reason for this is obvious, by engaging in such activities you actually avoid public scrutiny. This is unacceptable in the context of public debate in a democracy. It's high time we called them on this each time they pop up in the public domain and decide it's time to tell us how we ought to live our lives. Reminding them of their own endemic historical moral failings is perhaps the perfect hook on which to hang doubts about their moral authority (just in case you prefer a historical as opposed to a straightforward normative argument). Which reminds me, why I should suffer as a result of their sectarian celebrations - I can't even buy food today, the gym is closed, etc etc. Why is it seen to be fair game that their celebrations may impact legitimately on my life and that of Muslims, Buddhists, Hindus and any number of others who are not Christian God people?

And here ends my Easter sermon.

Update on Catholic anti-life doctrine and sexual abuse in the Roman Catholic Church

Update: March 02, 2010. I have received further information on the issue discussed in this blog entry, from Catholics for a Free Choice in the USA.

Here's an excerpt from a report they published in 1998: 'The US bishops' Ethical and Religious Directives for Catholic Health Care Services, which strongly prohibit abortion in Catholic hospitals, also say that "operation, treatment, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child."

"It may seem that this directive permits all life-saving abortions, but that is not the case. The language closely mirrors Catholic teaching on abortion, which forbids direct abortions in all circumstances, even to save the life of the mother. The word "direct" is critical. Indirect abortions are allowed - but there are only a few cases where this applies. In a case where a woman's life was threatened by pregnancy, abortion is directly intended and therefore not permitted.

"The full meaning of the directive played out in 1998 when a pregnant woman on Medicaid in need of an emergency abortion was denied services at a merged hospital in Manchester, N.H. The 35-year-old patient, who had miscarried in the last year, rushed to Elliot Hospital when her water broke at 14 weeks. When she arrived her physician determined she needed an emergency abortion in order to prevent a life threatening uterine infection and other complications. However, because Elliott had merged with Catholic Medical Center in 1994, abortions were banned in 1997 from Elliot at the insistence of its Catholic partner.'

It would appear as if the article in The Interim - Canada's Life and Family Newspaper has been as widely off the mark as I suggested in my initial entry... oh well, now there's a revelation!

In other news, German media report today on the ever growing scandal indicating widespread sexual abuse of pupils in Catholic monasteries and denominational schools in Germany. Also, in what's probably a first, there's been a police raid of a Jesuit monastery in Germany related to the scandal. It is well time that this organisation is being treated like any other organisation that has its hands seriously dirty! I never understood why shouting 'God' would somehow justify putting guys in skirts above the law... The number of victims that has come forward is running into the hundreds and more are coming forward each day. Quite naturally, the church hierarchy does not at all think that celibacy might have something to do with this. Well, I hope you like Il Papa's red Prada shoes... -

What surely is amusing is that these guys still have the nerve to tell us about morality!

Human dignity and individual liberty

There is an argument going on among well-intentioned and more or less knowledgeable bioethicists about the question of whether there is much use in deploying the concept of 'human dignity' in resolving conflicts about normative questions in the field. Here is a good critical take on the issue.

Typically the issue of dignity is wheeled in by opposing sides when they don't like the stance held by the other side, and they have no good arguments left to defend their own take on the matter. Here's a few examples: voluntary euthanasia and physician assisted suicide. There's opponents of physician assisted suicide and voluntary euthanasia who claim that such means to end a persons life are not dignified. Certainly the Roman Catholic Church thinks so. If you know anything at all about this debate, you will know that 'Death with Dignity' is also the battle-cry deployed by voluntary euthanasia groups. The same concept is used without blushing by groups for diametrically opposed means. That's odd indeed.

Up to this point I talked about the concept of dignity as if there was one. Of course, if neither the euthanasia folks nor the anti-euthanasia folks are able to demonstrate that the other side is wrong in their use of the concept of dignity, quite possibly there is something wrong with the concept, or, more to the point, quite possibly there's no concept.

Is voluntary euthanasia the exception pointing to a small problem with the idea of 'dignity', or is there actually more evidence that 'dignity' might just be a vacuous motherhood-and-apple pie thing suitable for and against anything and nothing. Well, in fact, there's plenty of other examples. IVF and artificial insemination (to go the the other end of our lives) are in the same boat as euthanasia. Christians routinely argue (well, claim) that our dignity is violated if we use such means of modern reproduction, allegedly because it's against our nature to do so. Of course, they don't mean a matter-of-fact type nature, they mean their normative understanding of what our nature should be like. It is well known that people who require access to such means of reproduction think their their dignity as rational agents is violated if the state or others prevents them from exercising such a choice (gays and lesbians come to mind, for instance). Both sides deploy the idea of 'dignity' to advance their diametrically opposing stances! Odd indeed.

Pornography is another, and my last example. There is no consensus at all about the question of whether someone violates his her or dignity (and that of others) by watching or participating in the production of pornographic material.

The German enlightenment philosopher Immanuel Kant initially understood respect for someone's dignity really as respect for a rational, autonomous agent. In that sense, dignity is kind of a short for respect for autonomous persons. That probably is a sensible thing. All other things being equal, we should be respectful of at least the self-regarding actions autonomous beings wish to undertake. May be that is what we should be saying, however. Of course, since then religious folks and invariably the UN have stepped in with a deluge of dignity here and dignity there declarations and statements that resulted into dignity being reduced to a campaign tool for everything and nothing at all. Christianity, for instance, quickly removed the Kantian criteria of reason and rationality and agitated for embryos' dignity, and human rights related claims derived from those. In case of doubt the supposedly necessary respect for these embryos' alleged dignity was used to override women's interest in controlling what's happening with their bodies. The UN has declared, for no good ethical reason at all, that reproductive human cloning is dignity violating. This emperor certainly is naked! Human dignity, warm and fuzzy as it may sound, is a useless tool for advancing arguments on any of the relevant fronts in bioethics. This insight is true regardless of the substantive stance that you'd take on any of these controversial issues, by the way. Dignity really is just a rhetorical tool as opposed to a serious conceptual means to advance discussions on these issues.

Today we are probably well advised, should we face the need to make a snap-decision, to reject dignity related claims unless these claims have another rationale attached to them that is based on some other framework. If anything, you'd probably right if you assumed that more often than not human dignity is deployed as a means of preventing people from making self-regarding choices.

Cult of Misery at it again

in Brazil this time around. Quite remarkable story, and yet in line with the Roman Catholic Church's complete and utter disregard for anyone alive and kicking (as opposed to the oh-so-infinitely-valuable 'unborn'). Here's what happened:

Medical doctors assisted a 9 year old girl with having an abortion. She had been raped by her stepfather over several years, eventually resulting into a pregnancy (with twins). The young girl would have been unable to give birth to the twins even if she had wanted to do so. Her doctors pointed out that the girl's uterus was plain too small to permit her to give birth to one child, let alone twins. The Cult of Misery's ideology wants it that pregnant women will - in case of conflict - be sacrificed for the sake of the great 'unborn', so no big surprise that the church organization worked tirelessly to prevent the abortion from taking place.

Brazil currently has pretty much a stone age type legislation in place with regard to reproductive health issues. Abortions may only happen legally in Brazil if one of two conditions are met: a) the pregnant woman's life is at risk, and/or b) rape has taken place. In the tragic case under consideration both conditions were sadly met, and accordingly doctors were permitted to undertake the abortion.

The Cult of Misery's local representatives, probably deeply concerned about the raped survivor's life having been preserved by the medical intervention, have since decided to punish those concerned with the decision making and execution. Their harshest punishment is deployed against the medical professionals as well the young girl's mother: excommunication. In case you're not a member of the Cult, you need to understand that if you're excommunicated you won't go to heaven and you won't enjoy eternal life. That's the deal on offer from the Cult for its members.

What's interesting about this case is this: the decision to excommunicate the doctors and mother (recall that their call on the abortion issue preserved the rape survivor's life) goes hand in hand with another decision made also by the church hierarchy, namely to revoke the excommunication of a holocaust denying catholic bishop. Gives you a fair idea why so many refer to the Roman Catholic Church as the Cult of Misery. The organization seems to have a knack for spreading misery, a lot of it.

Should Planned Parenthood Accept Racists' Donations?

In the USA pro-life groups are currently running a campaign designed to smear Planned Parenthood with the claim that the pro-choice organization accepts knowingly donations from racists, and, as a corollary that it is a racist organization. Here's what happened: a pro-life activist group called Planned Parenthood offices across the USA. Their caller pretended to be a racist wanting to earmark a donation toward assisting African American pregnant women to have an abortion. To leave Planned Parenthood staffers in no doubt about his racist agenda, the caller made clear that he's concerned that his fictional white newborn might suffer as a result of affirmative action policies and so he wants to have his donation go toward the abortion of a 'black baby' (no doubt he meant fetus, but that's neither here nor there, and pro-lifers usually miss out on nitty-gritty details such as developmental stages of embryos).

So, Planned Parenthood staffers across the US told him that they'd happily accept his donation (and earmark it according to his wishes). Nobody said: we do not accept donations from racists. Pro-life groups are trying currently hard to give the impression that individual staffers were motivated by racist motives, but a fair evaluation of the videos the group posted on youtube suggests nothing of that sort. Planned Parenthood has always taken a liberal, pro-choice stance on the abortion issue, so it could not say that it takes donations to assist women of all colors to have abortions if they so wish, whatever their reasons, unless they happen to be African American. So, Planned Parenthood then offers termination of pregnancy to African American women as well as to women of any other skin color.

Comes the racist donor along. Well, of course there can't be an issue for Planned Parenthood in terms of accepting the donation! Big deal. If you've some racist idiot who wants to give a million dollars to Planned Parenthood so that more African American women can be assisted in having a termination of pregnancy, the organization should accept the money. End of story. African American women, like any other client of the organization ask to have a termination of pregnancy out of their own free will. So the money would not suddenly go toward forcing African American women to have abortions that they do not wish to have. If anything it would assist more such women to access affordable reproductive health services.

Just as importantly, perhaps, is of course that the donation provided by the racist would free the organization to re-direct financial resources to women of other color, including white women wanting to have an abortion (probably much to the horror of the racist).

So, here's that big old lesson then one more time: It's not motives that matter, but outcomes. In this hypothetical case, everyone would be better off: the racist is happy, because he thinks he served a racist cause (little does he know that he didn't, of course); African American women, because more of them would be able to access Planned Parenthood's services; women of any other color, including white women, because more money would be available for them after the donation earmarked for black women.

Pro-life activism, intellectually impoverished as it is, seems to know no shame in terms of how it campaigns for its causes. To produce videos linking Planned Parenthood to the KKK and trying to align themselves with Martin Luther King jr's civil rights movement is breathtaking.

Hitler was a vegetarian, Stalin an atheist, Osama bin Laden a Muslim

I am sure you all at one point or other have heard (or, worse, deployed) an argument like this: Hitler was a vegetarian, ergo something got to be wrong with vegetarianism (vegetarians are probably all more or less on the verge of becoming genocidal mass murderers); or: Stalin was an atheist, ergo atheism is responsible for the pogroms Stalin presided over; or: Osama is a Muslim, ergo Islam is responsible for the mayhem currently taking place all over the world.
It will not come as a great surprise to readers of my blog that I am quite content with exonerating vegetarianism and atheism, but I am uncertain as to Islam. The reasons for this are fairly simple, neither Stalin nor Hitler used atheism or vegetarianism (respectively) as their ideological rationale trying to justify their murderous activities. Say, Hitler didn't go about saying, 'because I think eating animals is unethical, I think we should slaughter plenty of Jewish people'. These two things were unrelated. The same is true for Stalin. Stalin also did not justify his mass murder with reference to atheism. He murdered millions of Russians for entirely unrelated reasons.
The same, however, cannot be said with regard to Osama bin Laden (and many like him), whose main frame of ideological reference and justification for their continuing terrorist activities is indeed their religion - Islam. The same holds also true for fundamentalist Christian fanatics who have killed people working in reproductive health facilities in the USA.
So, the argument that Stalin was an atheist and that therefore atheism is a bad thing is false, while the argument that Osama bin Laden is a Muslim and therefore Islam is a bad thing cannot be brushed away in the same vain. One would probably have to show that Osama bin Laden's interpretation if Islam is false, which does not seem to be easily done, or else he would not have the number of followers he seems to have all over the world.

More on 'Faith' Schools

While the debate is raging in Canada about Mr Tory, the Conservative Party's aptly named leader's idea to pour more tax monies into faith schools, here's an interesting news item about these sorts of outfits in the UK. The Catholic Church, a known progressive force in international human rights circles, has issued a directive to 'its' schools in Northern Ireland to disband amnesty international support groups due to the human rights organisations support for abortion rights. So, if you ever had any doubt that these schools were truly about education first and not about ideology transfer.... think again.

God week continued: No to conscientious objection in medicine or elsewhere

Usually in the context of the abortion controversy, religiously motivated health care professionals claim the moral (and often legal) right to conscientious objection to the provision of certain health care services. The basic idea is that if, say, Christian doctors and nurses object for religious (conscience) reasons to abortion they should not be forced to provide such services. On the face of it this seems uncontroversial. I think both accepting such conscience based refusals to provide health care services as well as assuming that such decisions are uncontroversial is mistaken. Let me explain why.

First things first: health care professionals such as doctors and nurses are first and foremost called upon by us as members of society as professionals and not as members of the Communist Party, the Klu Klux Clan, the local chess club, or a particular church. They provide a public service. In return for this we as society grant them a monopoly on the provision of such services (eg doctors have a monopoly on the provision of many health delivery services, including the prescription of drugs). We as society also invest substantial amounts of public funds into their training.

In many countries abortion is legal to some extent or other. In other words, societies have decided that it is ethically acceptable for women to make such choices (usually within certain well-defined limits). In societies providing public health care, women are entitled to receive abortion services through health care professionals that are publicly funded. These professionals are seen by pregnant women for the purpose of having an abortion. They are sought out as professionals and not at all as private individuals with their own private views on the morality or otherwise of abortion. I think it is preposterous to suggest that such professionals could kind of opt-out of the provision of some services because they feel strongly about such services.

Religious provisions are more or less arbitrary. Some make sense, others don't, and among religions there is little consensus on what is and isn't ethical. To permit the delivery of health care to be controlled by what amounts essentially to a lottery is unacceptable. Patients treated by a public sector doctor belonging to Jehova's Witnesses wouldn't get blood transfusions, those falling into the hands of an adherent to the Scientology Church won't receive antidepressants, the list is endless. It's easily imagineable that a racist doctor belonging to a suitably racist church could refuse to provide life-preserving services to patients from ethnicities other than her own. The conscientious objection to abortion crowd might not like to hear this, but there is no in-principle difference between their objection and that of the medic belonging to the Aryan Nation Church of Jesus Christ Christian. They will, of course, claim that they have 'better' reasons and that the competing church (ie the smallish racist outfit) is either not a 'real' church or that the racists are 'wrong' etc. The thing is, strictly speaking, none of this can be shown to be true, because, as it happens all monotheistic religions depend on untestable claims about the existence of 'God'.

A reliable delivery of health services (and this include equitable access) depends on guaranteeing timely access based on health need. Conscientious objections are a serious threat to precisely that. If you are a pregnant woman living in a rural area with a limited number of predominantly conservative Christian or Muslim doctors you might well not be able to execute your legal right to have an abortion at a certain point in time, if respect for conscientious objections was considered to be of greater importance than your access to services. This argument is very powerful indeed, when you consider the dearth of health care professionals serving the public sector in developing countries.

So, the sooner we get rid of the right to conscientious objection, the better for us, the public. And to be clear, if health care professionals feel strongly enough about this matter, they should be invited to leave the profession and do something else with their lives. We cannot reasonably permit a pick-and-choose type interpretation of professionalism to become the norm.

As someone who has taught for many years in medical schools, I can testify to quite a number of people who have chosen dentistry over medicine, for instance, because they did not wish to ever have to face the moral conflicts that come into play in the abortion controversy or end-of-life decision-making. In all honesty, these professionals deserve our respect for what I think is a grown-up understanding of what it means to be a professional.

British Medical Association Medical Ethics Committee on Access to Abortion

The British Medical Association's Medical Ethics Committee has issued a day or two ago a position statement on access to abortion in the UK. The organisation has been in favour of women's legal right to abortion since the 1970. I excerpt here the BMA's key opinions. In a number of key areas the organisation proposes to make access to abortion easier for pregnant women. This is quite significant, seeing that it comes immediately in the aftermath of public debate in the UK about the Roman Catholic Church's hierarchy clamouring to have abortion outlawed altogether. You can find the whole report here.

The MEC supports the revision of the Abortion Act 1967 so that, in the first trimester:
• women are not required to meet medical criteria for abortion
• the requirement for two doctors is removed
• suitably trained and experienced nurses and midwives may carry out both medical and surgical abortions
• as long as safety is ensured, premises do not need to be approved to carry out first trimester abortions.

The MEC believes:• that changes in relation to first trimester abortion should not adversely impact upon the availability of later abortions
• that health professionals with a conscientious objection to abortion should retain the right to opt out of providing abortion services, but should make their views known to patients and enable them to see another doctor without delay.

The MEC believes that the requirement for medical criteria should be removed for first trimester abortions.

The MEC believes that the requirement for two doctors’ opinions should be removed for abortions within the first trimester.

The MEC believes that the level of training and experience a person has is the most important factor in determining which procedures should be undertaken by which professions. The MEC has no objection, in principle, to nurses and midwives, with appropriate training and competence, carrying out abortions.

The MEC has no objection in principle to removing the requirement for premises to be “approved” for first trimester abortions and allowing medical abortions to take place at home where that is the woman’s wish.

Celibate man in dress continues to ramble on about abortion

Well, this bloke is Keith O'Brien, the Roman Catholic Church's CEO in Scotland. He also goes by the designation of Cardinal (which is an old word that translates loosely in modern English into CEO). Anyway, CEO O'Brien gave a sermon (that's a speech in modern English) the other day to his flog of supporters in Edinburgh. Having recently lost an important policy battle in the country (his organisation may not discriminate against gay people - pretty shocking to our dress wearing celibate), O'Brien turned his theological gaze toward another one of his company's favourite topics, abortion. He compared the number of abortions taking place on a daily basis in Scotland to the Dunblane massacre. In Dunblane, sixteen kids and a teacher were shot by a lone gunman. Obviously to the man who likes to wear red dresses in public there is no significant moral difference between abortion and the murder of children, teenagers and adults. All the same to him.
I have no intention to get into the pro's and con's of abortion again. In a way, being a card-carrying humanist, I don't mind O'Brien rambling on like this. The more hysterical, and, frankly, silly, his public utterances become, the greater the irrelevance of the organisation he runs in Scotland is likely to become. And that, probably, is a good thing. The less people listen to 'moral' pronouncements, and the kind of bullying and hectoring that emanates from characters like Mr O'Brien the better for our societies.
I am concerned, however, by the overwhelmingly negative response he received from the media. Many commentators suggested that he overstepped the mark and that he shouldn't try to influence elected politicians' views and votes on this issue. Here I disagree as a matter of principle. Mr O'Brien is essentially a lobbyist for a conservative organisation. The organisation is known to hold radical views on abortion, euthanasia and many other issues. Surely in a democratic society lobbyists like Mr O'Brien are entitled to campaign for their views. It is up to mainstream society to reject their message. End of story. It would be a sad indictment of our democracy indeed, if Mr O'Brien could not have his say.

Oddities of Irish Life

Here's a story (well, more to the point, the satisfactory conclusion of a story): A 17 year of teenager in the Republic of Ireland sued to be allowed to leave the country in order to have an abortion in the UK. The Republic of Ireland is, in case you don't know, a fairly conservative, Catholic country. It has some of the most stringent abortion rules in Europe. The teenager in question tried to have an abortion in Ireland, thru the country's national health service. Well, this is not just your average abortion where a teenager tries to have a termination of pregnancy due to some accident that happened during sexual intercourse. Prenatal tests showed that the newborn would suffer from anencephaly. Newborns with that condition don't live for longer than three days after birth, due to the fact that a large part of the brain and skull is missing. The girl did not want to subject herself and the newborn to that ordeal and requested an abortion. This was denied by the Irish national health service. She then tried to do what many Irish women having abortions do, she tried to escape the country's draconian regulations and tried to have her termination of pregnancy in the UK. However, being under age the national health service ordered her not to leave the country.
The BBC reports today that 'The High Court has now ruled there were no statutory or constitutional grounds for preventing the teenager, known only as Miss D in court, from travelling to the UK for the operation.'
It seems reassuring that there are some sensible people left in that country. I mean, what's the point of carrying a foetus to term that has no life prospects whatsoever. Why would anyone wish to subject a pregnant teenager to the ordeal of having to have the baby in order to see it die within a few days? How could religious dogma initially be permitted to take priority over respect for the difficult choice this young woman made?