Between “Science” and “Superstition”: Moral Perceptions of Induced Abortion Among Young Adults in Vietnam

Despite the increasing use ofreproductive technologies the world over,anthropological studies have paid remarkablylimited attention to the ethical dilemmasinvolved in people's choices of suchtechnologies. Against this background, theauthor analyzes moral perceptions of inducedabortion among unmarried young adults in urbanNorth Vietnam. While the ethical aspects ofabortion are shrouded in silence in public lifein Vietnam, the young people participating inthe study expressed strong moral scepticismtowards the practice of abortion, even whileundergoing it themselves. Through the analysisof young people's experiences and perceptions,the paper demonstrates how moral ideas are tiedto particular social situations and structuredby larger socio-political circumstances. It isargued that moral notions which are dominant ina society's public sphere may not berepresentative of the moral sentiments that arelived in practice and felt in private.     

Abortion experience among obstetric patients at Korle-Bu Hospital, Accra, Ghana

Hospital admissions for complications of abortion have been increasing in Africa, indicating a rise in the incidence of abortion. In all pregnant women ever admitted to Korle-Bu hospital in Accra, Ghana, the chance that the outcome of their last pregnancy was an induced abortion decreased as the number of previous pregnancies increased. Women with higher levels of education were more likely to have their 1st pregnancy terminated in an induced abortion. Younger women were more likely than older women at each level of education to have an induced abortion terminate a 1st pregnancy. The use of contraceptives during the last pregnancy interval increased with the level of education of the woman and the number of previous pregnancies. Contraceptive use was also highest among women whose last pregnancy outcome was an induced abortion. The mean pregnancy interval decreased with increasing number of previous pregnancies for both women who used and who did not use contraceptives during their last pregnancy interval. But the mean pregnancy interval was higher among women who used contraceptives. It appears that the abortion experience in this region of Africa is most common in lower parity young women with high levels of education who desire to delay a 1st birth or to space births. This is in contrast in Latin America and other developing countries in which abortion is used mainly by older, married, urban women to limit family size. Contraceptive use in this region of Africa is low, indicating the need for more family planning programs and increasing use of existing programs.     

TWO STALEMATES IN THE PHILOSOPHICAL DEBATE ABOUT ABORTION AND WHY THEY CANNOT BE RESOLVED USING ANALOGICAL ARGUMENTS

Philosophical debate about the ethics of abortion has reached stalemate on two key issues. First, the claim that foetuses have moral standing that entitles them to protections for their lives has been neither convincingly established nor refuted. Second, the question of a pregnant woman's obligation to allow the gestating foetus the use of her body has not been resolved. Both issues are deadlocked because philosophers addressing them invariably rely on intuitions and analogies, and such arguments have weaknesses that make them unfit for resolving the abortion issue. Analogical arguments work by building a kind of consensus, and such a consensus is virtually unimaginable because (1) intuitions are revisable, and in the abortion debate there is great motive to revise them, (2) one's position on abortion influences judgments about other issues, making it difficult to leverage intuitions about other ethical questions into changing peoples' minds about abortion, and (3) the extent of shared values in the abortion debate is overstated. Arguments by analogy rely on an assumption of the commensurability of moral worldviews. But the abortion debate is currently unfolding in a context of genuinely incommensurable moral worldviews. The article ends by arguing that the default position must be to permit abortion as a consequence of the freedom of conscience protected in liberal societies.     

On Abortion: Exploring Psychological Meaning and Attitudes in a Sample of Mexican Gynecologists

Elective abortion has become an issue of ethical and political debate in many countries including Mexico. As gynecologists are directly involved in the practice of abortion, it is important to know the psychological meaning that the term ‘elective abortion’ has for them. This study explores the psychological meaning and attitudes toward elective abortion of one hundred and twenty‐three Mexican gynecologists. We used the semantic networks technique, which analyzed the words the participants associated with the term ‘elective abortion’. The defining words most frequently used by participants implied a negative sanction. There were important differences by gender and religiosity: male gynecologists, as well as those with strong religious beliefs (mainly Catholics), revealed a more negative psychological meaning and more negative attitudes than females or physicians with weak religious beliefs. A contribution of the present study is that it highlights the importance of psychology to enhancing understanding of the issue of elective abortion.     

Selective abortion in Brazil: the anencephaly case

This paper discusses the Brazilian Supreme Court ruling on the case of anencephaly. In Brazil, abortion is a crime against the life of a fetus, and selective abortion of non-viable fetuses is prohibited. Following a paradigmatic case discussed by the Brazilian Supreme Court in 2004, the use of abortion was authorized in the case of a fetus with anencephaly. The objective of this paper is to analyze the ethical arguments of the case, in particular the strategy of avoiding the moral status of the fetus, the cornerstone thesis of the Catholic Church.     

The ethical acceptability of animal experiments: a proposal for a system to support decision-making

We describe a system to support decision-making on the ethical acceptability of animal experiments for scientific researchers and others responsible for ethical decision-making in animal experiments. The system consists of eight steps. Each step contains a number of substantive questions or a computational rule, leading to a well-articulated moral judgment on specific animal experiments. The system comprises a number of moral assumptions and pre-emptive norms, but leaves enough room for moral discretion and personal responsibility. The general ethical ideas behind the moral choices and assumptions are sketched and potential objections to the overall approach are discussed.     

Conscientious objection in medicine

Recognition of conscientious objection seems reasonable in relation to controversial and contentious issues, such as physician assisted suicide and abortion. However, physicians also advance conscience-based objections to actions and practices that are sanctioned by established norms of medical ethics, and an account of their moral force can be more elusive in such contexts. Several possible ethical justifications for recognizing appeals to conscience in medicine are examined, and it is argued that the most promising one is respect for moral integrity. It is also argued that an appeal to conscience has significant moral weight only if the core ethical values on which it is based correspond to one or more core values in medicine. Finally, several guidelines pertaining to appeals to conscience and their ethical evaluation are presented.     

The discovery of the body: human dissection and its cultural contexts in ancient Greece.

In the first half of the third century B.C, two Greeks, Herophilus of Chalcedon and his younger contemporary Erasistratus of Ceos, became the first and last ancient scientists to perform systematic dissections of human cadavers. In all probability, they also conducted vivisections of condemned criminals. Their anatomical and physiological discoveries were extraordinary. The uniqueness of these events presents an intriguing historical puzzle. Animals had been dissected by Aristotle in the preceding century (and partly dissected by other Greeks in earlier centuries), and, later, Galen (second century A.D.) and others again systematically dissected numerous animals. But no ancient scientists ever seem to have resumed systematic human dissection. This paper explores, first, the cultural factors--including traditional Greek attitudes to the corpse and to the skin, also as manifested in Greek sacred laws--that may have prevented systematic human dissection during almost all of Greek antiquity, from the Pre-Socratic philosopher-scientists of the sixth and fifth centuries B.C. to distinguished Greek physicians of the later Roman Empire. Second, the exceptional constellation of cultural, political, and social circumstances in early Alexandria that might have emboldened Herophilus to overcome the pressures of cultural traditions and to initiate systematic human dissection, is analyzed. Finally, the paper explores possible reasons for the mysteriously abrupt disappearance of systematic human dissection from Greek science after the death of Erasistratus and Herophilus.     

Hellenism and Jewish nationalism: ambivalence and its ancient roots

This essay sketches the ambivalent relationship of Hebraism and Hellenism from ancient times to the foundation of modern Israel. It analyses classical Greek influence on the Jewish Enlightenment (the Haskalah) and modern Jewish nationalism, particularly as reflected in Hebrew literature. Greece's successful struggle for independence from Ottoman Turkey in the 1820s showed the early Zionists that an ancient nation could be resurrected. Also, the ancient Greek ideal of physical education, revived in nineteenth-century Europe, radically transformed both Christian and Jewish attitudes to the body, giving rise to two related movements, "muscular Christianity" and "muscular Judaism". As the assimilationist attempts of the Haskalah broke down in the late nineteenth century under the burden of anti-Semitism and European racial nationalism, "muscular Judaism" was incorporated into Zionism. Jewish nationalists largely rejected rabbinic spirituality, non-belligerence and the disdain for athleticism which had dominated Jewish life after Rome destroyed the Jewish state in 70 CE.     

Moral and religious influences on the amniocentesis decision

Abstract

As early as 1973 Fletcher documented moral problems families encountered as they struggled with the decision of whether or not to have amniocentesis. In this study we asked 202 women accepting and 50 women rejecting amniocentesis extensive questions about religious beliefs, behaviors, and beliefs about abortion. Members of small Protestant denominations were the most conservative. Catholics and other Protestants were intermediate with smaller differences between these middle groups. Those respondents claiming no religion or one of a non‐Christian denomination were the most liberal. Net predictors of acceptance of amniocentesis included respondents’ support for laws permitting abortion for medical reasons, negative responses about belief in the sanctity of life, having insurance, and the respondents’ political affiliation. Education and religious attendance were the most consistent net predictorsof moral attitudes. We concluded that the amniocentesis decision is influenced by many religious beliefs but is not completely determined by these.     

Report on the Moscow symposium on biological research in schizophrenia

Abstract

Genetic counseling, second trimester amniocentesis, reliable techniques for analyzing fetal amniotic fluid and selective abortion together have the potential to prevent a variety of serious birth defects. Advances in technique and/or changing patterns of childbearing may place a large number of women in age groups where genetic counseling programs are recommended. However, attitudes toward abortion may be a critical variable in ascertaining the potential of genetic counseling programs to reduce birth defects. If opposition to abortion is based on a moral commitment, greater awareness of genetic counseling programs will lead to opposition to these programs. If attitudes toward abortion are based upon an evaluative process, such opposition is less likely to occur. Using a sample of women from the Rochester, New York, area (N = 1,616) whose attitudes toward abortion match U.S. estimates, we find that the greater the knowledge about prenatal screening, the less prevalent are attitudes opposed to abortion in circumstances necessary for birth defect reduction. This relationship holds when controlled for religion and family size. We conclude that educational and counseling programs concerning the potential benefits of prenatal screening are unlikely to arouse opposition to these programs.     

Learning to navigate the ethics of boundaries: schools,youth, and inter-religious relationships in Manado,Indonesia

Contributing to recent debates on ethical self-making, this article considers how Christian and Muslim youth in Manado, Indonesia, draw on various moral frameworks, and consequentially on both individual and community-oriented modes of subjectivity in navigating inter-religious encounters. The discussion foregrounds attitudes towards and normative expectations regarding inter-religious marriage as an important lens through which the shifting salience of inter-religious boundaries becomes apparent. Public discourses emphasize two contradictory frameworks for coexistence, projecting inter-religious marriage alternatively as the foundation for coexistence and as a major social threat. A focus on high schools demonstrates how public ethical debates are channelled through institutions and relate to the ways that youth grapple with coexisting ethical frameworks in a religiously plural society. In addition, the article makes a case for investigating the role of institutions in moral learning, taking into account the normative work accomplished in schools as teachers and students deliberate about and circulate ethical frameworks.     

Attitudes of Obstetric and Gynecologic Residents Toward Abortion

As a follow-up to Wolf''s study of attitudes of obstetrical housestaff toward therapeutic abortion,⁵ the attitudes of 48 obstetrical residents in the San Francisco Bay area were evaluated by questionnaire and structured interview. Specific issues studied were: (1) Willingness to perform therapeutic abortion, (2) impact of therapeutic abortion on Resident Training Program, (3) attitudes toward different operational procedures, and (4) preferred physician-patient relationship with therapeutic abortion patients. Findings suggest that although there is recognition and acceptance by most residents of the social need for therapeutic abortion, considerable ambivalence persists.     

Genetic concepts in Greek literature from the eighth to the fourth century B.C.

Summary A review of the concepts of genetics found in epic, historical and dramatic ancient Greek writings from the eighth to the fourth centuries B.C., is presented. The derived data suggest that the development of genetical concepts and ideas started with the praise of the heroes' divine or noble origin in Homer's epic poems (eighth century B.C.). It continued in the tracing of the descent and vicissitudes of the families of the Greek gods and the common ancestry of the Greek tribes as described in Hesiod's genealogical poems (around 700 B.C.), in the statement of descent and dual parenthood of leaders and kings in the books of Herodotus and Xenophon (fifth and fourth centuries B.C.), and in the concern about the lineage of the tragic figures in Greek drama (fifth century B.C.). The genetical concepts expressed in these writings most probably reflected popular notions of that time. They must, therefore, have been the basis of the perceptions and theories on heredity and procreation expressed by the ancient physicians and philosophers in the fifth and fourth centuries B.C., which in turn influenced the development of genetics for many centuries.Dedicated to the memory of Ioannes Passas, my classics teacher     

Ethical dimensions of therapeutic human cloning

Therapeutic human cloning has the potential significantly to reduce human suffering and enhance human happiness. This is the main ethical argument in its favour. The main ethical arguments against it centre on questions to do with the moral status of the human embryo. A subsidiary set of arguments arises from the connections between therapeutic human cloning and reproductive cloning. Most of the ethical questions concerning the status of the human embryo have long been examined in the context of abortion, though they are being re-examined in the context of genetic screening and embryo research. A consensus on such matters seems extremely unlikely to result in the near future. The current role of ethicists may not, therefore, be so much to attempt to produce a definitive answer to the question of the status of the human embryo at the very early developmental stages at which therapeutic human cloning would take place, but more to help clarify arguments and indicate the implications of particular approaches. That is what this paper seeks to do.     

Parental virtue: a new way of thinking about the morality of reproductive actions

In this paper I explore the potential of virtue ethical ideas to generate a new way of thinking about the ethical questions surrounding the creation of children. Applying ideas from neo‐Aristotelian virtue ethics to the parental sphere specifically, I develop a framework for the moral assessment of reproductive actions that centres on the concept of parental virtue. I suggest that the character traits of the good parent can be used as a basis for determining the moral permissibility of a particular reproductive action. I posit three parental virtues and argue that we can see the moral status of a reproductive action as determined by the relationship between such an action and (at least) these virtues. Using a case involving selection for deafness, I argue that thinking in terms of the question ‘would a virtuous parent do this?’ when morally assessing reproductive action is a viable and useful way of thinking about issues in reproductive ethics.     

Attitudes towards abortion in the Danish population

This article reports the results of a survey, by mailed questionnaire, of the attitudes among a sample of the Danish population towards abortion for social and genetic reasons. Of 1080 questionnaires sent to a random sample of persons between 18 and 45 years, 731 (68%) were completed and returned.
A great majority of the respondents were liberal towards early abortion both for social reasons and in case of minor disease. In contrast, there was controversy about late abortions for social reasons and in the case of Down syndrome. Further there was strong reluctance to accept late abortion in case of minor disease.
An analysis of the response patterns showed that most of the respondents had gradualist views on abortion, i.e. they would allow all early abortions, but only abortions for some reasons later in pregnancy. It was also found that the number who would find an early abortion acceptable in general was much higher than the number who would accept it in their own case. These findings suggest that a great part of the resistance towards abortion does not rest on a concern for the rights and interests for the fetus. Instead it may be explained on a view according to which fetal life is ascribed intrinsic moral value.     

Abortion and neonaticide: ethics,practice, and policy in four nations

Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform.     

Pregnancy and the risk of autoimmune disease

Autoimmune diseases (AID) predominantly affect women of reproductive age. While basic molecular studies have implicated persisting fetal cells in the mother in some AID, supportive epidemiological evidence is limited. We investigated the effect of vaginal delivery, caesarean section (CS) and induced abortion on the risk of subsequent maternal AID. Using the Danish Civil Registration System (CRS) we identified women who were born between 1960 and1992. We performed data linkage between the CRS other Danish national registers to identify women who had a pregnancy and those who developed AID. Women were categorised into 4 groups; nulligravida (control group), women who had 1st child by vaginal delivery, whose 1st delivery was by CS and who had abortions. Log-linear Poisson regression with person-years was used for data analysis adjusting for several potential confounders. There were 1,035,639 women aged >14 years and 25,570 developed AID: 43.4% nulligravida, 44.3% had their first pregnancy delivered vaginally, 7.6% CS and 4.1% abortions. The risk of AID was significantly higher in the 1st year after vaginal delivery (RR = 1.1[1.0, 1.2]) and CS (RR = 1.3[1.1, 1.5]) but significantly lower in the 1st year following abortion (RR = 0.7[0.6, 0.9]). These results suggest an association between pregnancy and the risk of subsequent maternal AID. Increased risks of AID after CS may be explained by amplified fetal cell traffic at delivery, while decreased risks after abortion may be due to the transfer of more primitive fetal stem cells. The increased risk of AID in the first year after delivery may also be related to greater testing during pregnancy.     

Substance,rights, value,and abortion

Most serious contemporary opposition to abortion is grounded on the belief that human fetuses are members of the same moral category as beings like us, and that the loss of any such life is one of the worst possible losses. Substance view theorists oppose abortion for this reason: in their view beings like us are essentially rational substances with inherent moral worth, and those who perform induced abortion fail to recognize this moral worth. In a recent series of articles, Rob Lovering presents reductio‐style arguments against the substance view, in part arguing that it is inconsistent with our intuitions in rescue and spontaneous abortion cases. In a recent reply, Henrik Friberg‐Fernros argues that the substance view can evade these problematic implications because of a distinction between killing and letting die. According to this argument, the fetus’s right to life is a negative right not to be killed, not a positive right to be rescued, thus the anti‐abortion theorist who lets fetuses die acts acceptably. I argue this stance fails to recognize the inherent moral worth that the substance view contends fetuses possess. One who refrains from saving a person, or doesn’t care how many people she saves, cannot reasonably claim to value life. Furthermore, this stance is at odds with most contemporary anti‐abortion views that oppose induced abortions of both the killing and letting die variety.