Wednesday 22 May 2013

The Abortion Debate – Reluctantly leaving the Middle Ground!

When the current abortion debate blew up in the wake of the Savita Halappanavar tragedy and the ABC case I wrote to the Irish Times Letters page (Published Nov 22nd 2012) arguing for the ‘Middle Ground’ to makes its voice heard so that we could progress beyond the extreme polarity of the ‘Pro-Life’ & ‘Pro-Choice’ campaigns. I am not going to repeat all the points I made on that occasion but in essence I suggested that this is a complex issue which is ill-served by either ‘side’ demonizing the other. Sadly and despite the attempts of people far more qualified and influential than I the middle ground has not really been heard and we are if anything becoming daily more polarized on this issue. The debate around suicidality in particular has driven into a cul de sac and only addresses a tiny fraction of the issues around abortion.

On a personal level I too (to my surprise and a certain amount of discomfort) have become more polarized and I wonder am I alone in this. Leading into the current debate my position would have been that abortion should only be available in cases of rape, unviable pregnancy and a threat to the health and/or life of the mother. My inclusion of the threat to health as well as life would it seems to me be justified in the light of the ambiguity over the transition from threat to health to threat to life in the Savita  Halappanavar case.

I would not have been and am still not in favour of abortion on demand. I certainly do not want abortion to become an alternative form of contraception.  Equally I would hate to see abortion used as a means of genetic selection where pregnancies of Downs Syndrome or other Special Needs were routinely terminated. I say this as the parent of a child with Special Needs who has brought untold joy to my life and that of my wife.

My views on abortion are not merely speculative in that in my ministry I have encountered the issues outlined above where I feel abortion should be available. Incidentally in my experience abortion has not always been and indeed was rarely the desired choice of the mother but it is my belief that that choice should be there.

So what has changed? Where do I stand in the wake of the debate to date? Well in the absence of a middle ground I am forced to make a hard choice and I do so fully conscious of the potential for many of the things that I do not want to see happen become a reality.

In my original letter to the Irish Times I regretted the at times casual regard for the life of the foetus by many in the ‘Pro-Choice’ camp and I went on to say that to minimize the reality of abortion as the termination of a life is to ‘undermine our own humanity’. However I find even more disturbing the approach of many in the ‘Pro-Life’ camp and I still stand over what I wrote in that earlier letter:

When it comes to the ‘Pro-life’ group the principal fault is ironically the failure to take seriously the life of the mother. Their pro-life stance is somewhat selective. The mother is portrayed as a vessel whose sole purpose is to support the life within her with no account for her own humanity, welfare and integrity. Her motivations in choosing abortion, no matter how traumatic or medically necessary, are ignored and her actions are described in terms of murder regardless of the circumstances. This is cruel and for want of a better word tantamount to misogyny.’

There are times in ones life when a choice has to be made. Choice is part of what it means to be a human being. Many of the choices we face are not black and white and we do not always have the luxury of chosing between what is obviously good or bad, right and wrong.  I believe that abortion is such an issue and that for any of us from a distance to presume we know what is right in any given circumstance is at least naaive and perhaps more than a little arrogant.

There are a number of factors which sway me. As the debate has continued I have become more and more uncomfortable with the predominance of male voices who pontificate on this issue with little if any sympathy for the complex variety of situations in which women considering abortion find themselves. Yes there are ‘pro-life’ women too but I think we as men need to ask ourselves a question before we even presume to weigh into this debate: How would we feel if we were the one’s who had the privelege and the pain of childbearing? The answer is we don’t know and thus all our contributions should be made in the context of respect for the role of women in child bearing and humility in the light of our own inevitable ignorance.

I am also increasingly concerned at the level of amateur interference in medical issues that this debate has fostered. We are putting doctors in an impossible situation as we attempt to second guess their every decision.  There is something quite bizarre about non-medical politicians, clergy (of any church) and others trying to argue medical technicalities with highly qualified consultants and other medical specialists.  Our doctors need to be given clear and unambiguous guidance in principle by legislators  and then given the necessary level of trust to perform their duties and maintain the integrity of the doctor/patient relationship which is hugely undermined by the proposed legislation.

I have deliberately not until now argued my position from a religious perspective as I am not under the illusion that we religious have a monopoly on wisdom or on respect for life. However I do think there is something within the Christian tradition which speaks quite powerfully on this issue and that is our role as Co-Creators with God. We human beings as well as being created have been given the ability to create life and that is our choice. We are not forced by God to do so. Even Mary, the Christ bearer, was given the choice to say yes or no to bearing the Incarnate Lord. Her yes is at the root of the faith of those of us who call ourselves Christian. This may be irrelevant to those who are of another faith or of no faith and if so feel free to disregard but to those of us who profess a Christian faith I think the cooperation of Mary as Mother is something we should reflect on.

On a pragmatic level I am also increasingly swayed by the fact that we already have abortion in Ireland. Its simply that we export the implementation of it and in so doing condemn women to an often lonely and frightening journey to foreign shores. Here they have non of the support structures of friends and family and even on arrival home are afraid to disclose what they have experienced. In some cases where post-abortion complications arise this is potentially life threatening and does not reflect well on our compassion as a nation. What we don’t know may not hurt us but this 'fool's paradise' we choose to live in is hurting women every day.

And finally it comes down to TRUST. If we are to truly respect the role of women in childbearing then we have to trust them with that role without subjecting them to the kind of overbearing oversight that is proposed in the new legislation. Yes all life is precious and deserves respect but that includes the lives of  women who must face the joys and agonies of childbearing and childbirth and all the complexities that involves. Their ‘yes’, and even their ‘no’ is something which we must respect.

And so if you haven’t already realised I have vacated the Middle Ground and must now declare myself  Pro-Choice. I do so because I feel that I must trust women with the integrity of their own bodies. The alternative is to be party to a culture of coercion and enforcement which takes from women that most fundamental right of determining their own role in Creation. That is for me fundamental to their humanity and to mine.


droid said...

Fair play. Courageous and compassionate reasoning. I wonder how many others have been swayed by the spectacle of career pro-lifers wheeling out their increasingly disturbing arguments?

Anonymous said...

Grest post. Thank you for being so honest with your feelings.

Póló said...

Thank you for that very honest and reflective post.

I have always been conflicted on this issue, having been raised as a (male) Pius XII Roman Catholic, and not escaped from the old RC contraception view until the latter stages of University.

I have ducked the abortion issue as I have felt completely conflicted; both sides have annoyed the hell out of me for years, and, most importantly, the issue has not arisen for me in a personal way.

I do now feel, however, that this time I have to make up my mind, and I found your reflections very helpful.

I think I'm with you on this one.

I hope our trust is not abused.

Stephen Neill said...

Droid - thank you kindly - I reckon there are quite a few who feel this way in the light of the 'debate'

anonymous - thank you :)

Póló - I can identify with the conflicted thing but as you say we now have to make a decision. Re trust - I hope so too

Anonymous said...

Thank you very much for your powerful reflection. It had never ocurred to me before that Mary was given a choice

Anonymous said...

Well put. I agree that we have to trust that people in this very sad position will not take this option lightly. Criminals are presumed innocent until proven guilty. Surely a compassionate society should not judge women so harshly.

Unknown said...

Very interesting, honest and compassionate point of view. It's nice to see people weigh up the pros and cons of abortion in a non-biased way.

Unknown said...

Very honest, clear and interesting read. It's nice to see people weigh up the pros and cons of abortion in a non-biased way.

Eimear said...

Stephen, you are certainly not alone in your opinion and I think most of the 'middle ground' has come to the same conclusion. I am glad as a woman that this is being debated openly and would also not personally be in favour of abortion-on-demand. However, we need to make that first step in protecting mothers in complex medical situations without non-medics interfering

Kevin M said...

Great article, thoughtfully written.

Where the law must weigh the life, health and rights of the mother vs. the fetus we are forced into a lesser of two evils decision. I quite agree that the life and health of the mother should take precedence. Also, termination in the cases of rape or incest may be the least bad solution.

Abortion in the US, which was to be legal, safe and rare, has turned out to be anything but.

The debate here has been morphed from the original Roe v. Wade definition into the right to abortion on demand, for any reason, at any stage of pregnancy. Not a serious medical decision balancing the competing rights of two living human beings but a commonplace and mundane procedure of convenience.

Well over 40 million babies have been aborted since Roe v Wade when they originally calculated 10,000 per year.

Be careful.

Anonymous said...

I found reading your article really, really helpful. Thank you. I relate pretty closely to your previous position and your new position on the issue, and your piece helped me to realise that and to articulate my developing position to myself. I particularly appreciated the respect for women you exhort and model yourself.

I am female, and thankfully have never found myself pregnant except when I heartily wished to be so. I conceived four times, suffered two miscarriages and have two children who are among the brightest lights in my life. I am now asking myself 'How hard would it be to go through with a pregnancy that was NOT wished for?' Not just in cases of rape and other horrendous circumstances, but simply if you felt this pregnancy was derailing your life? Would it be extraordinarily difficult to love, rather than resent, the resulting child? Hard questions, indeed. Caitlin Moran's book - I think the title is 'Becoming a Woman' or something like that deals with this predicament authentically and sensitively, with the decision to seek a termination the resolution in her case. Brave writer. As are you.

Anonymous said...

a well crafted, reasoned response stephen. thank you. and as a woman raised in the church of ireland who has made that decision and that lonely journey, i applaud your honesty and frankness. if only more on both sides of the polar extremes could use such measured language. love and peace. x

Anonymous said...

Thank you, thank you Stephen. Thank you for your trust in women.

Anonymous said...

At last some words of real wisdom about an issue that when discussed in the media can only be described as a sea of misinformation and point scoring.

Stephen Neill said...

Thank you each one of you for all the generous and constructive comments - you all deserve an individual response and I know some of you are speaking out of direct experience of these issues and I thank you for sharing your unique insights - I think judging from the hits on this post (1000+ since last night) there are a lot more people out there who don't want this issue hijacked by the Black & White Brigade.

Anonymous said...

Thank you for this post. It's thoroughly refreshing to read such a thoughtful, humble and compassionate argument from a 'man of the cloth'. I only wish such contributions weren't so rare.

As an Irish woman of child-bearing age I've grown up with abortion. I was a few years younger than X at the time of the X case. I feel that part of my maturation, (and I would hope the maturation of our nation) has been to lift the veil of shame and secrecy surrounding female sexuality. But the polarity of the current abortion debate is disheartening.

During my lifetime I've supported friends who made the journey to England. I've failed one who asked me to accompany her. I've witnessed the death of my friends newborn who died of what would have been termed a fatal foetal abnormality had it been detected prior to birth. I've counselled women and girls who suffered rape and sexual abuse. And I've witnessed the joys of pregnancy and birth, planned and unplanned, where that pregnancy was wanted.

Life is complex, and the intersection of two lives under any circumstances is even more so. Abortion is not an easy choice to make under any circumstances, and I've never come across any woman who took that choice lightly - nevermind in a country where they are vilified, ridiculed, and criminalised.

I really don't feel it's helpful to couch support for a woman's choice with 'I hope our trust is not abused' (Polo above, and author in agreement). This statement perpetuates the suspicion of women that drives the 'pro-life' debate, and assumes some measure of moral authority of another person's body. I find that idea quite threatening.

The greatest challenge of Christianity is idea that one should 'judge not'. Can Ireland really proclaim itself Christian if the debate on such topics be centred around the harsh judgement of raped and abused women and girls, or the heartbreaking decisions of those unfortunate enough to suffer fatal foetal abnormality, or those young girls and women who decide that they simply cannot (for whatever reason) continue a pregnancy?

I've never been what you might call actively pro-choice. I've never joined a demonstration until Savita Halappanavar died. My sister happened to be pregnant at the time. During her pregnancy we discussed 'contingency plans' of how to get her out of Ireland should she have the misfortune of suffering the same fate. Until that point I'd always been tolerant of the 'pro-life' view point, but at that moment I grew up again and realised that 'pro-life' laws endanger women.

I still respect the 'pro-life' position. I understand and think it's a noble proposition that life begins at conception and should therefore be protected. However, that position can only be a personal one, it cannot be allowed to endanger women's lives any longer. Savita's death, and the realisation of the vulnerability of my pregnant sister, flushed me out onto the streets.

I've come to see the pro-choice stance is a spectrum of positions, the common ground is the recognition that women should make choices which they deem best for their own lives. Welcome to the new middle ground.

Eleanor said...

Thank you for your bravery, sense of justice and compassion and clarity of thought.

Unknown said...

Just another voice that adds a note of thanks for adding a thoughtful and compassionate voice to this issue.
Usually I favour a middle ground on many issues in the hope of ensuring inclusivity of various views, perhaps it's the teacher in me :)
However, some issues do require us to move closer to either the yin or the yang, as to stand in the middle may allow injustices to occur at either end of the scale.

Unknown said...

I too have a difficulty with dehumanising unborn babies. At the same time I firmly believe... both instinctively and after lengthy thought and research..that the life and wellbeing of the woman in whose body the baby is growing must take precedence. The concept that a fertilised egg and a two year old child should have the same right to life makes no sense to me. Nor can I reconcile my own respect for life with the Catholic Church's preference that both mother and child be allowed die if the alternative is abortion. How could anyone think that's what God would want? In an ideal world there would be no abortion but blissful ignorance of reality - of people's lives and of the more horrifying aspects of owning a womb- should not be an excuse for our continued exporting of problem pregnancies.

Stephen Neill said...

To Anonymous: Re your comment below I read Polo's comment as meaning trust in the integrity of my position not as you interpret but I am now not sure which he meant. I would absolutely agree with you and no certainly Trust is Trust - end of!

'I really don't feel it's helpful to couch support for a woman's choice with 'I hope our trust is not abused' (Polo above, and author in agreement). This statement perpetuates the suspicion of women that drives the 'pro-life' debate, and assumes some measure of moral authority of another person's body. I find that idea quite threatening. '

Stephen Neill said...

Eleanor - Thank you for such kind words :)

Mia - Beautifully put and I fully agree

Lorraine - Yes I just cant get my head around this equality of a four cell embryo with a mother who is perhaps also a sister a daughter a lover a wife a friend - An essential part of our humanity is realised in relationship and I think that this is overlooked in the simplistic view taken by some. Sometimes as I said in my post we have to make choices and not to is also potentially the wrong thing to do - i.e.. in the Christian context 'things done and things left undone'

Anonymous said...

I think this is a very thoughtful and well-reasoned post.

Listening to the recent debates on abortion, it has struck me that the pro-life side of the debate considers that there is potential for women to choose to have an abortion in a casual or flippant manner.

I would rather believe, as your article puts very well, that when such a choice is presented, no matter how difficult, a women will make the best decision she can. There is no objectively perfect choice, but rather women will make the optimal choice in their circumstances, no doubt with a heavy heart either way.

I choose to allow such choices to be unfettered, as we are only here in the first place because of loving, responsible and compassionate women.

Stephen Neill said...

Anonymous - thank you - I do like your last point especially

Jason said...

Many thanks for your insightful comments and compassionate response.

A couple of things do come to mind:

In relation to Savita's case: I still can not understand why the Principle of Double Effect was not invoked at the first clinical indicators of Sepsis. This Principle has a significant place in medical and nursing ethics. If it had been invoked, Savita would have had the abortion and be alive today;

In relation to suicidal ideation: again the Principle of Double effect comes into play. The life of the mother takes precedence where she is in extremis.

I personally would also consider those pregnancies where the foetus is inviable outside the womb. It is sheer cruelty to force a mother to bring to birth a child that will die within a matter of minutes of it coming into the world.

If Thomas Aquinas could allow abortion in some circumstances, then the church itself must be a little more flexible.

And the church has a less than honourable history in the way it has cruelly treated the victims of suicide (ie not allowing burial in consecrated ground, condemning the person to hell) and leaving their families and friends with horrendous psychological baggage in view of such practices. Thank goodness that the church has moved on.

As a Nurse and an Anglican I did find it very unhelpful that Michael Jackson and Sam Harper tried to muddy the waters with the inclusion of the father of the foetus in the decision making process re abortion. Coming from a place of experience: we deal with the mother in the first instance. The mother has absolute authority over her body. The husband/partner is secondary to this. If the woman does not want her husband/partner involved in her care, then we are obliged morally and legally to deal with the mother only. This helps to prevent any undue, inappropriate psychological interference/bullying from other persons who may not have the woman's best interests at heart. (And this principle is applicable to all patients).

Whilst I do not want to see abortion on demand, like you, I agree that the only compassionate and humane response is to allow abortion in certain circumstances where the life of the mother is compromised. I would also include those cases where the foetus is inviable after birth.

Maybe as Christians we need to reflect on the Cartesian dualistic notions that have crept into our spirituality. Maybe if we treated the person holistically instead of bodies and minds (medicine and psychiatry is another expression of this), as minds inhabiting bodily machines, and all that is spiritual = good and holy, whereas all that is physical is bad and evil. Maybe then we could embody much more care, compassion and insight into our understandings and experiences of life than we currently do.

Again, many thanks for putting your head above the parapet and trying to bring some sanity to a debate that is rapidly turning into mud slinging - to the detriment of women in particular, and all of us in general.

I hope and pray that Ireland will enact a law that is reflective of all of the above before another woman dies.


Stephen Neill said...

Jason - yes to everything you have said - I value your particular insight as a medical professional who obviously has done a lot of thinking about this. I had the very same reaction to you when ++Michael Jackson made ref to the role of the father in the decision re abortion - I think it was unfortunate and unhelpful. I don't think it was in his and Sam Harper's submission to Oireachtas but did hear it live at the Synod Press Conference - he was being pushed hard by reporters mind you but has not to my knowledge pulled back from it.
You speak absolute sense and yes re the unviable pregnancy issue of which I have had a few experiences of in my ministry - they should have the option to terminate the pregnancy - Not all will but option should be there. I see there are moves afoot to bring an ammendment to the legislation to include them. It will be fought tooth and nail but hopefully we will get something a little more coherant than the mess around suicidality.
Again thanks for the comment.

Póló said...

@anonymous 23/5/13 17:05
@stephen 24/5/13 09:45

You referred to my concluding remark on trust and abuse thereof.

Perhaps the phrasing was not the best but what I was trying to say was that I hope that, at the end of the day, what is done will respect the qualifications in your own attitude which you expressed, for example, in this paragraph in your post.

"I would not have been and am still not in favour of abortion on demand. I certainly do not want abortion to become an alternative form of contraception. Equally I would hate to see abortion used as a means of genetic selection where pregnancies of Downs Syndrome or other Special Needs were routinely terminated. I say this as the parent of a child with Special Needs who has brought untold joy to my life and that of my wife."

We have no guarantee on this. That is why I used the word trust. We are relying on a host of people here, including the women themselves, legislators and medics.

Anonymous said...

"Whilst I do not want to see abortion on demand, like you, I agree that the only compassionate and humane response is to allow abortion in certain circumstances where the life of the mother is compromised. I would also include those cases where the foetus is inviable after birth." - Good and worthy comment on this situation. It would be nice to think that everyone would adhere to this sentiment.

However the difficutly in all of this is that once the genie is out of the bottle you cannot get it back in.

To be informed we should look to the standards of other countries where abortion was made legal with great intentions. Those great intentions have grown and now we see that they have grown to include lifestyle choices, a financial saving to the State and for some a form of birth control.

Life is sacred and if you acknowledge God then you know thats true. Relying on humanity alone to behave with care in these matters is blinkered thinking.

Jason said...

Dear "anonymous"

Many thanks for your thoughts.

It sounds like that you may be using the "thin end of the wedge" argument to state that a difficult moral philosophical and theological choice should not be made.

Whether we like it or not, nothing is straightforward when dealing with such moral dilemmas.

All that anyone has is our humanity in such decision-making. God does not give us ready-made answers. We are called to make mature decisions in difficult situations, hoping that we are making such decisions that resonate with our experience of God.

In a life and death situations (in extremis) issues of the economy, or social/lifestyle choices do not come into the equation. The same can also be extended in those situations where a foetus will be inviable after birth; a choice here ought to be given to the mother.

The law being debated here in Ireland is still going to be highly restrictive. I well appreciate that in other jurisdictions some women do use abortion as a form of contraception, or for other lifestyle choices. However, my personal experience of medicine in the Republic is that it is quite conservative in it's decision-making. Medical professionals take very seriously their ethical and legal responsibilities in their practice. And the penalties - legally and professionally - are an effective deterrent to unethical practice. This can actually be observed in the report concerning the case of Savita. Whilst mistakes were made, it is quite clear that the medical professionals were actually paralysed in their decision-making as to whether or not to go ahead and undertake an abortion in this case. They feared the legal and professional consequences of their actions had they gone ahead and aborted Savita's foetus.

It has been a good twenty years or more since the X case and other similar cases. We have procrastinated too much. And whilst we have procrastinated, we are blindly (?conveniently)allowing women to go to the UK to have terminations. This means that these women are not getting the appropriate after care and support that they need (physically, psychologically, emotionally and spiritually). It is also exporting our problems to another jurisdiction, because we do not have the maturity as a people to sensitively and effectively deal with our own problems. That is hardly an acceptable ethical approach that a state should take.

As I stated in my original comment, Thomas Aquinas is someone we have to remind ourselves of. He plainly allowed abortion in certain circumstances. A respected saint and Doctor of the Church is difficult to contradict here. Whilst the church brushed this aspect of his theology under the carpet, the church has never condemned or rejected his theological insights on this matter outright. The church - us- needs to be flexible here.

In an ideal world both the mother and foetus would be saved. But we do not live in an ideal world, and God is not like some magician in the sky who is going to wave a magic wand and make things right. Instead, we live in a messy world, where exceptional morally ambiguous decisions have to be made in very limited time frames.

In an emergency situation we do not have weeks, months and years to play with. If we are lucky we have days; we may have hours, but normally we have minutes and seconds in which to make decisions that alter a persons life irrevocably. And we carry those decisions around with us for the rest of our lives.

So, if you were in my shoes what would you do? What is the truly compassionate response to these situations?

Many thanks for your comment, and I appreciate your concern in relation to this very difficult matter.


Mikhail Ramendik said...

I am sorry, Stephen, but we are on different sides on this issue. I do not do active pro-life campaigning (because, like you, I feel that as a male it it not very appropriate, so I prefer to support pro-life women). But I firmly believe in the right of every human being to life, which can not be taken away simply because another person threatens to kill him- or herself.

I support abortion only in cases where killing a born person would also not be criminal. It is not criminal to kill to save one's life.

And this is not about religion, it is about recognition of rights in secular law. Once we state that "society", not God or nature, determines basic rights of a human being, we open the floodgates to complete arbitrariness. Unborn today - non-native-born (like me) tomorrow.

What if some opponents of immigration threaten to burn themselves unless every non-native born person is deported? Would you support shipping me out of the country to support their demand? And that would not kill me. Then why would you support abortion if the mother threatens to kill herself? What is the difference between one human and another human?

Yes, I will be at a pro-life rally if Limerick gets one (and I hear of it and can make it...). Might end up the only non-Catholic there.