Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications.
Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.
He is admitted to the practice of law in New York State and Rhode Island, and is a licensed New York City sightseeing guide.
Appel contributed a Dangerous Idea to Big Think's "Month of Thinking Dangerously," advocating that we add trace amounts of lithium to our drinking water to help reduce the suicide rate.
Appel is a Big Think Delphi Fellow.
Question: How should bioethicists think about abortion, and where do you stand on the issue?
Jacob Appel: Well, I think the two questions that a bioethicist has to ask in the abortion debate are; one, is it a question of when life begins, or is it a question of either permitting or prohibiting abortion based on independent phenomena. If you are interested in the question of when life begins, then the motivation for the pregnancy should be utterly irrelevant to your decision-making. If you believe that a fetus attains a personhood past a certain age, even if that fetus is the product of rape or incest, it wouldn't make sense to allow someone to terminate a pregnancy if you believe that fetus is personary.
In contrast, there are other reasons one might oppose abortion rights independent of when the fetus begins -- when the life begins. One might say, I acknowledge that fetuses aren't human beings. Life doesn't begin until birth. But if we ban abortion, we reduce the likelihood of teenage pregnancy, sexually transmitted disease; we can reverse the social and sexual revolution of the 1960's. Which many people do advocate and do believe, and from their point of view, whether or not the fetus is a human being isn't a relevant question.
I think as a society today and bioethicists particularly have largely focused on the question of when life begins. I am fairly radical in my views in the sense that I would permit abortion up to the point of birth. I think that the arbitrary distinction that fetuses apply or personhood at a certain point is simply too grey an area, a too uncertain premise to enforce in law. The example always use, and it's somewhat trivial, but at the same time evinces the question well, I think, is small children making Jello. If you have a small child making Jello, they put the colored water in their refrigerator, they run away, they come back 30 seconds later, they put their finger in the Jello, is it colored water or is it Jello. And they do this over and over again until suddenly and miraculously it becomes Jello. The development of a fetus operates the same way. Birth is an easy guideline. The truth is, since I believe that sentience and cognition, or consciousness define life, there probably are infants in the first few days of life who don't really have cognition. Who don't have in this sense, sentience, but for a practical, realistic way of running the world, we couldn't live in a world where we euthanized them, or allowed infanticide.
That being said, I would also add as a bioethicist, I have written extensively on treating infanticide, and particularly mothers with post-partum depression and post-partum psychosis, as distinct from other murderers and other criminals. I think we should grant great latitude to women who kill or euthanize their infants at birth and treat them with kindness as someone who suffers from illness.
Question: Why make birth the dividing line and not a certain phase of pregnancy?
Jacob Appel: I think that is fairly simple. The ancient Romans, for example, didn't view birth as the cutoff point. They had a certain number of days, and it varied where in Rome you were before a child gained full personhood. The ancient Spartans certainly didn't view infants at birth as having human capacity or human value. We have a very hard time distinguishing whether a child once born is three days old, or seven days old, or two months old. And you don't want to have a system that has courts engaged in the process of figuring out exactly how many days old the baby was. And having people's lives and their prospect of going free or spending time in jail dependent on exactly how many days they were post-birth.
So, my actual philosophical drawing line would be far past birth in terms of days or weeks. But there's no practical way to implement that. You could easily figure out how many days before birth, or how many trimesters, how many weeks a fetus was by ultrasound, but there is not a point along that parameter where I would feel that a child or a fetus has enough capacity and enough sentience to be considered a human being.
Recorded on March 1, 2010
Interviewed by Austin Allen
The objections to all of these phenomena are really not what people say they are.