Life and Choice

January 22, 2022 • Posted in Blog

Janet Liljestrand, M.D., M.A.

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In 1862 Louis Pasteur performed the definitive experiment that proved even the smallest organisms, those only seen under the microscope, derived from other like organisms. (1) Life came from life. Fast forward to 1973, and Justice Blackmun, writing for the majority decision in Roe v. Wade stated “We need not resolve the difficult decision of when life begins”. (2) What was the Justice’s definition of life? The human zygote contains all it needs for cellular division–and thus growth–at the union of a living sperm and living egg. How then has its human life not begun? Yes, in the natural world, not all zygotes will continue to live, but if the subsequent embryo does survive, all the mechanisms to bring that about are present at the moment of conception.

I graduated from medical school the same year that Roe v. Wade was decided. I learned before that time that the heart began beating about 4 weeks post conception. Prior to CPR and a designation of brain death, a beating heart meant you were alive and a non-beating heart meant that you were dead. It was not complicated. CPR intends to return the heart to beating and the body retains life. Brain death in essence means that the brain is so severely damaged rendering its regulatory mechanisms no longer working, that if life support is removed, and eventually even with life support, the heart will stop beating as well. The unborn child has the natural “life support” of the mother, but unlike the brain dead, with time, the child will no longer need that support. What was the “difficult decision” about when life began, when the timing of the heartbeat was already known as was the fact that life only comes from life? Perhaps, Justice Blackmun was not concerned about physical life, but the moment the unborn achieved the moral status as a person.

Ultrasound has allowed expectant parents to “see” their unborn child well before the due date, and, yes, the child’s beating heart. No longer is abortion about when life begins. It is now worded in terms of a woman’s right to make health care choices regarding her own body. Hence the Texas law forbidding abortion once the unborn has a heartbeat is couched as an attack on the rights of women. Yet, this same beating heart will eight months later be beating in a newborn baby; almost half of those newborns are female. (3) Right of bodily integrity, in an age of near worship of autonomy, is more palatable than arguing that a woman should have the right to kill her own child.

With abortion readily available, are women given more choice or less? In my exam room sat a clearly depressed teenage young woman. As I elicited social history, her mother reluctantly recounted the circumstances of the young woman’s abortion and what was, in my opinion, her own coercive role. I don’t recall the mother’s exact words as she ended, but they were something like the following: “I don’t like abortion, but under the circumstances, we had no choice.” The tears flowed down my patient’s face and she refused to speak. Obviously, she understood that abortion stopped the heartbeat of her unborn child. I believe she would have liked to have had a real choice. Perhaps the choice to love her unborn child.

The Tennessee Center for Bioethics & Culture encourages respectful discussion and debate of bioethics issues, and strongly supports freedom of speech. To that end, we invite and welcome other voices to the discussion of bioethics issues. Invited authors’ views are their own, and do not necessarily represent those of The Tennessee Center for Bioethics & Culture.