The Case for Permitting Abortion Until Birth
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 bioethicist argues that humans do not gain real sentience until infancy, and that even mothers who commit infanticide should be treated far more gently than other murderers.
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What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
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