Beyond the Abortion Wars, Chapter 3: The Drugged Gunman and the Violinist

Before I get to Chapter 3, this piece on abortion polling is well worth a read (h/t to Elizabeth S. Bruenig via Twitter).  It supports and reinforces some of the points Camosy makes in Chapter 1 about the nuances in people's views on abortion.  It also brought out an element that I've never seen captured in polling, but is true in my anecdotal experience--people really don't like abortion protesters.  A number of otherwise pro-life individuals that the reporter spoke to made clear that they thought that picketing clinics was improper.  Substantial majorities, well beyond the number of people who think abortion should be legal in all or most cases, felt that those women who do get abortions should be able to do so "informed by medically accurate information" (87%), in a "non-judgmental" context (74%), "comfortabl[y]" (72%), and "without added burdens" (70%).  More on this is later posts.

On to Chapter 3, which is oriented around the question of how to think about the act of an abortion itself.  For Camosy, the critical question is whether abortion (in terms of a specific abortion in specific circumstances, or in general) should see seen as the direct killing of the fetus, or whether it should be seen as a decision to "refuse to aid" the fetus, leading to the fetus's death.  For Camosy, following along with Catholic moral theology, to the extent an abortion is a direct killing (more specifically the direct killing of an innocent human being) it can never be morally acceptable, while if it is a refusal to aid it might indeed be morally acceptable.

Before getting to Camosy's analysis, it is worth pointing out that not everyone thinks that the distinction Camosy is attempting to draw here is a meaningful one.  For example, in the criminal law context, the Model Penal Code considers a "purposeful" killing (defined as one that in which "it is [the killer's] conscious object to . . . to cause such a result" i.e. the death of the victim) and a "knowing" killing (defined as "[the killer] is aware that it is practically certain that his conduct will cause" the death of the victim) to both be murder in equal measure.  A classic example of a "knowing" killing in the MPC context is to deliberately starve someone; if you starve someone, it is "practically certain" that you will kill them, and so it is murder just as if you shot them.  Likewise, if you considered a "direct" abortion (i.e. the "purposeful" termination of the fetus) to be murder, then a "failure to aid" might very well also be murder.

I bring this up not to argue that Camosy's distinction is ridiculous or improper; the MPC after all makes a distinction between purposeful and knowing, even if it doesn't consider it relevant in the murder context (or, as it turns out, most criminal contexts in the MPC scheme).  But Camosy acts as if the distinction is self-evident, and much of his abortion analysis turns on this distinction.  It's not self-evident, and I can see many people rejecting this distinction.  And if they reject this scheme, they are going to have a hard time with the rest of what he is saying.  Moreover, it reflects, and we are going to see this more clearly later, a lack of recognition that people have very different philosophical approaches to these questions.  That doesn't mean that Camosy should not be free to advocate for his own framework, but I think it is helpful to acknowledge these alternative frameworks, rather than glossing over the problem.

In any event, back to Camosy's analysis.  For Camosy, surgical abortions--dilation and curettage (D&C) or dilation and evacuation (D&E)--cannot reasonably be described as "refusal to aid" the fetus, and so must be seen as "direct" abortions.  It's hard to argue this point.  Though, he gets a little wobbly when he mentions that sometimes the purpose of the abortion is not to end the pregnancy, but actually end the fetus's life (using the example of parents who abort fetus's with Down's Syndrome, a clear neuralgic point for him).  That is of course a thing that can happen, but it points out the problem with his direct/fail to support distinction.  One could imagine taking a medication that causes the woman's body to reject the pregnancy out of a desire of causing the fetus to die (say, to use his example, because it has Down's Syndrome).  That seemingly confuses his two categories.

Camosy seems to take an absolute moral position against direct abortions.:

So whether it is the means by which the end of their action is accomplished or the actual end itself, a direct abortion aims at the death of the fetus.  And because persons are beings who cannot have their dignity reduced in this way, these direct abortions are always wrong.  

But, not so fast.  Camosy at this point makes an interesting conceptual move, one that I have not seen anywhere else.  The direct killing of an innocent life is morally unacceptable, but the direct killing of a non-innocent life is not always--think self-defense.  And, if the mother's life is in danger, there is a sense that the fetus is the source of this life-threatening danger.  Thus, the argument follows, there is a sense that the fetus is not innocent.  To flesh out this argument, he raises the interesting example of someone who is out of his mind on drugs and with a gun (and, to keep it simple, let's say this person was drugged against his will).  Our insane shooter is "innocent" in the sense that he is not intending harm to others, but nevertheless it would justified to use deadly force in self-defense if necessary.

I honestly don't know what I think of this move.  On the one hand, I think it is a cleaner justification for the "life of the mother" exception than the standard Catholic Principle of Double Effect (which often runs afoul of the purposeful vs. knowing problem I mentioned above).  On the other hand, it does stretch the definition of "innocent" beyond its usual bounds.  I also wonder about the logical extension of this idea.  For example, imagine an incurable, contagious plague.  On Camosy's theory, it seems to me that an infected person would be "materially non-innocent" to its fellows due to the danger of infection, and thus it would potentially be justifiable to kill them to prevent the spread of the plague.  On the other hand, maybe that's right.

After a couple of arguably unnecessary detours (including a guilt trip for taking vacations as opposed to giving money to charity), we come to "failure to aid."  He begins by looking at a common analogy used in abortion debate--the dying violinist hypothetical.  For those not familiar with this analogy, imagine that you wake up one morning lying in a hospital bed with a series of tubes running out of your arm.  Those tubes lead to the arm of a famous violinist.  Before you can figure out what is going on, a doctor comes in an explains that, indeed, you have been kidnapped, but that they did so because your blood contains a rare compound necessary to keep the violinist alive.  If you were to remove the tubes which circulate your blood to the violinist, he or she would die.  But, to keep him or her alive, you are going to have to stay in this bed, or at least otherwise stay attached to the violinist.

The question posed by this scenario is whether or not you are morally justified in removing the tubes from your arm, knowing that the violinist would die.  Those that propose this hypothetical suggest that the answer is yes--your right to bodily integrity and autonomy override any potential obligation to the violinist.  From this, the move is to say that the violinist is basically in the same place as the fetus--dependent entirely on the pregnant woman to provide life sustaining support.  If you think that someone is justified in disconnecting the violinist, so the argument goes, you should think that it is OK to have an abortion.

Camosy points out, correctly in my view, that this analogy does not perfectly line up with most abortion scenarios.  Under the violinist hypothetical, the donor's connection to the violinist is entirely involuntary and is a fait accompli by the time the donor is aware of it happening.  In the majority of scenarios, the sequence of events leading to pregnancy is not entirely involuntary, at least insofar as the woman voluntarily has sex that results in pregnancy.  How and to what degree that changes the analysis is subject to debate, but it is a distinction that should have some relevance.

Camosy, though, points out that the violinist scenario tracks perfectly with one abortion scenario--pregnancy as a result of rape.  As we will see, cases of rape loom large in his thinking about when abortions might be acceptable, and I think it is fair to say that his reasoning is informed in large part by the violinist hypothetical.  Adopting a bright line between the rape scenario and the non-rape scenario in the context of the violinist analogy implies, however, the view that having consensual sex is de facto consent by the woman to a pregnancy.  In other words, if you think that the violinist hypothetical applies in the rape context and not in non-rape contexts, what you are really saying is that it is the kidnapping part of the violinist hypothetical provides the moral justification for pulling the plug on the violinist, not the bodily integrity argument per se.  Once you are no longer hooked up to the violinist entirely against your will, on this view, the analogy breaks down.

That's a perfectly defensible position, and I agree to with it to some degree.  I will say, and this is going to be a thread running through this book, that I would find the idea that a woman who has consensual intercourse has also consented to getting pregnant much more convincing if the woman had unfettered access to birth control.  To say that one must take responsibility for the possibility of pregnancy, and then deny or limit access to the means that one might do that, is to place women in a Catch-22.  Camosy tries very hard to bracket the birth control question throughout the book, whether because he personally opposes birth control, or because he knows that endorsing birth control makes any proposal radioactive for a certain segment of his Christian (especially Catholic) readership, or both.  But there is no question that his views on parental responsibility are going to get a much colder reception if there isn't a way to prevent becoming a parent in the first place.

This is particularly true because Camosy has a very expansive understanding of the duties of parents.  For example, he is dismissive of the idea that the mental health of the mother is a legitimate basis for an abortion, under the heading that "[a]ll parents of children (both prenatal and postnatal) have their psychological health affected."  That's, frankly, a troubling dismissal of the reality of mental health and mental illness, but for our purposes now it speaks to Camosy's core conviction that getting pregnant means taking on the whole basket of responsibilities, and having consensual sex means taking on the possibility of getting pregnant.  Thus, for Camosy, the only justifiable "failure to support" abortion is in cases of rape.

A couple of last points.  First, when Camosy talks of "failure to support" abortions, as a practical matter he is thinking of RU-486, which cuts off the hormones that sustain a pregnancy, leading to a miscarriage.  The problem with RU-486 is that it only works in the earliest phases of pregnancy.  Since Camosy opposes direct abortions, as a practical matter abortions are limited to week eight.  That is a very, very narrow window, but more about that in later posts.

Second, Camosy cites a (to me) surprising statement from the Connecticut bishops conference authorizing providing emergency contraception to rape victims.  In particular, I was surprised by the statement that the use of Plan B "cannot be judged to be the commission of an abortion because of such doubt about how Plan B pills and similar drugs work. . . ."  I am pleased to see the Connecticut bishops are distancing themselves from this unscientific and discredited talking point about Plan B and hormonal contraceptives in general.  Perhaps the Connecticut bishops, and even Camosy, should be more pro-active in refuting this talking point when it comes up among Catholic anti-contraceptive advocates.  Which is essentially all the time.

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