When considering the ethics of abortion, it is not enough to show that the foetus is human, or even that the foetus is a human person with the same right to life as a newborn baby, or a grown adult. 

Not that debates about the moral status of the unborn aren’t extremely important, but it can actually be helpful to think about the discussion around abortion as encompassing two fairly separate debates. This is because we also need to think about whether the woman’s right to bodily autonomy, her right to determine what happens to her own body, trumps the foetus’ right to life. Arguments for this conclusion are often called ‘bodily rights’ arguments. The idea is that, even if the foetus is a human person, and even if it would be good for the woman to carry her pregnancy to term, we can’t force her to do so because she has a right to decide what to do with her own body. Muireann has written a very compelling response to this kind of argument. 

I’ve also written about one famous bodily rights argument, the violinist argument. This argument sometimes seems too far-fetched to be compelling to people with strong pro-life views and instincts. But there’s another forceful way of making the same kind of point – one that Muireann has talked about in presentations –  by thinking of unwanted pregnancy as a kind of temporary forced organ donation.

Building up to the pro-choice analogy

We tend to think that it is wrong to force people to donate their organs, even if doing so would save lives, or hugely improve a patient’s quality of life. We might think that it is very morally admirable to voluntarily donate organs as a living donor. We think well of the many people who have donated one of their kidneys to friends or relatives for example. Perhaps more impressive still, are the ‘altruistic donors’ who voluntarily donate kidneys to strangers. 

But I think we would be horrified, if we found that someone had forcibly removed someone’s kidney so that someone else could use it. (Unfortunately, forced organ harvesting is something that really happens, and is considered a crime against humanity.)  Even a forced organ donation was the only way of saving an innocent person’s life, most people would not condone it. 

This isn’t just a hypothetical possibility. To consider one example of a real case like this, take a case that took place in the US, in a Pennsylvanian court, in 1978,  McFall vs Shimp. A 39-year-old man, Robert McFall, suffered from aplastic anaemia, an incredibly rare bone marrow disease. It was determined that without an urgent bone marrow transfusion, he would die. It turned out that the only available bone marrow match was a first cousin of McFall, David Shimp, who was three years older than him. Despite the fact that the donation would have hugely increased McFall’s chances of survival – from somewhere close to zero, to fifty or sixty percent – Shimp refused. Then, McFall sued Shimp in an understandable attempt to save his own life and force his cousin to donate the bone marrow he needed to survive. 

The judge, John P. Flaherty Jr., condemned Shimp’s position as “morally indefensible”. Nonetheless, he decided in his favour, refusing to force him to donate bone marrow on the grounds that this would “would defeat the sanctity of the individual and would impose a rule which would know no limits, and one could not imagine where the line would be drawn.” It’s easy to understand where the judge was coming from: the possibility that as a society, we could force people to donate organs to others is one that most of us would be more comfortable considering as the premise of a dystopian science fiction novel than as a real political possibility. 

The pro-choice analogy

But, someone might say, the McFall vs. Shimp case bears some resemblance to situations where a woman is pregnant and wants an abortion: 

  • McFall will die if he does not receive a bone marrow donation from a bone marrow match. He needs one to survive. 
  • His cousin Shimp is the only person who can do this. He is the only person who can save McFall and if Shimp does not donate his bone marrow, McFall will die. 
  • Shimp is McFall’s relative. We might think that he has more duties to his younger cousin than he might have to a stranger.
  • Still, if Shimp refuses to donate the bone marrow, it is wrong to force him to do so.

Why, a pro-choice person might say, can’t we extend the same logic to women who want abortions? The situations seem closely analogous in many morally relevant ways:

  • The foetus will die if the foetus is not the ‘recipient’ of someone else’s uterus. The foetus needs this to survive.
  • The foetus’ mother is the only person who can do this. She is the only person who can save the foetus and if she does not donate her uterus for this purpose, the foetus will die. 
  • The mother is the foetus’ relative. We might think that she has more duties to her child than to a stranger.
  • Still, if the woman refuses to donate her uterus, it is wrong to force her to do so.

If we think that forcing someone to donate an organ is wrong even if doing so is the only way to save another human being’s life, why don’t we feel the same way about forcing a woman to use her uterus to sustain someone’s else’s life against her will? 

How to respond to this argument by analogy

One way of understanding the general idea behind this argument is to think of it as ‘an argument by analogy’ and  break it down into three steps:

  1. There are good reasons to think that it is wrong to force Shimp to donate his bone marrow to his cousin.
  2. There are good reasons to think that the reasons we have for thinking this also apply to cases where a woman wants an abortion. This is because the two cases are similar in morally relevant ways. (This is the analogy.) 
  3. It’s inconsistent to think that it is wrong to force Shimp to donate his bone marrow and also think that it is not wrong to prevent a woman from having an abortion

One way to respond to this argument would be to take issue with 1. and argue that the judge made the wrong decision in the McFall vs. Shimp case. This would be pretty controversial! Another way of responding is by questioning 2. That’s what I’ll do here.

There are several responses you could make to this argument, but I will focus on two. Both out dissimilarities between Shimp being forced to donate his bone marrow and banning access to abortions. 

  1. Forced Organ Donation vs Forced ‘Organ Retrieval’ 

Imagine that the McFall vs Shimp case had played out differently. Let’s say that the judge ruled in favour of McFall instead and that Shimp was forced to donate his bone marrow. Let’s also grant the assumption that this was the wrong ruling, that the judge unjustifiably infringed on Shimp’s bodily autonomy in doing so. Then, Shimp sues McFall in a new case, Shimp vs. McFall, in which it is now Shimp who argues that McFall should give him his bone marrow back, on the ground that it is his bone marrow, and perhaps also on the ground that it was wrong to take it from him in the first place. McFall refuses to ‘give the marrow back’ because he still needs it to survive. It is not at all clear to me that Shimp has the right to forcibly retrieve his bone marrow, especially given that doing so would kill McFall. In fact, I would be inclined to say that he does not: now it is McFall’s bodily integrity – as well as his life –  that is being threatened, so the grounds for that previously favoured Shimp now arguably favour McFall. At the very least, I think it’s hard to see a clear and strong case to be made for Shimp having the right to take the marrow back. 

But the pregnancy case is actually more similar to this make-believe case than it is to the original one. In pregnancy, it is not as if anyone is asking a woman to welcome an embryo into her womb, and she is refusing this ‘request to enter’. The foetus is already inside her uterus, and she is attempting to ‘retrieve it’ when doing so would now violate the foetus’ bodily integrity and cause the foetus’ death.  She is not like Shimp in the real case, who is being asked if he will donate his marrow to save someone’s life, she is like Shimp in the imaginary case I’ve just described, who is demanding  his marrow back, when he knows that doing so will violate McFall’s bodily autonomy and cause his death.  (We might think that the ‘pregnancy’ equivalent of the real scenario is someone being forced to ‘adopt’ a leftover embryo from an IVF clinic)

And so, despite initial appearances, thinking about McFall vs Shimp does not lead to the conclusion that if organ donation is wrong, we should not prevent people from having abortions.

  1. Not saving vs. Killing 

This imaginary case also draws attention to another difference between forced organ donation and abortion.

When Shimp is asked to donate his bone marrow, he is being asked to do so to save McFall’s life. When he refuses, he fails to save McFall. When, in my imaginary scenario, Shimp demands that McFall return the marrow that was donated to him, he is attempting to do something that would effectively kill McFall. Similarly, when someone fails to ‘adopt’ an abandoned embryo from an IVF clinic, they fail to save a life. But abortion is clearly an action that pro-actively ends a life, that kills. And so, again, we have another significant disanalogy, and so the pro-choice ‘argument by analogy’ that I outlined above doesn’t look like it really shows what it’s intended to. 

We tend to think that we should prevent people from killing, but not that we should legally oblige them to save lives. (It might actually be worth challenging the idea that we should never legally oblige people to save lives, especially when a particular person is the only person who can save a vulnerable person’s life. As a recent ERI video points out, while there are also many situations where there is a decision between helping, and not helping, where not helping isn’t the same thing as killing, which would be its own third option (I can help the person asking for money on the street, or fail to help them, or I can murder them. But failing to help isn’t the same thing as killing.) But there are also others where not helping is tantamount to killing. (Someone can jump into the back of a trailer van belonging to a group of people fleeing a forest fire. They can help the person by letting them stay on the trailer, or they can fail to help by pushing them off. But here, pushing the person off seems to almost count as killing them, not just as a failure to help.) But that’s a matter for another day! For now, it’s enough to note that we think that we should prevent killing.) 

Conclusion

The forced organ donation arguments can seem powerful when you first hear them, and it’s helpful to understand why so as to avoid straw-manning people who disagree with the pro-life position. But I also think that they ultimately fail.

Ciara