Intro to Abortion - Bioethics 5e by Vaughn PDF

# Chapter 7: Abortion ## Lewis Vaughn Abortion is among the most contentious and complex issues in bioethics. It has divided the public, exercised politicians, occupied the courts, busied the media, and engendered violence. Much of the public debate has been bitter and irrational, driven by partis...

# Chapter 7: Abortion ## Lewis Vaughn Abortion is among the most contentious and complex issues in bioethics. It has divided the public, exercised politicians, occupied the courts, busied the media, and engendered violence. Much of the public debate has been bitter and irrational, driven by partisans bent on racking up political points and by popular media obsessed with keeping score. But away from the scuffle and out of earshot of the quarrelers, a more useful debate has been going on - the philosophical give and take among thinkers who test claims about the morality of abortion through reasoned argument and careful reflection. They have achieved no grand consensus on the issue, but they have plumbed it, clarified it, and wrung from it some thoughtful answers worth considering. They have, in other words, done bioethics. Let us see, then, what this work can tell us. ## Starting Point: The Basics Views on abortion - whether held by church, state, or citizenry - have varied dramatically through time and across cultures. Abortions in the ancient world were common, and there was no shortage of methods for effecting them. Some writers of the time condemned the practice, and some recommended it. "Let there be a law that no deformed child shall live," says Aristotle, "and if couples have children in excess, let abortion be procured before life and sense have begun." The Hippocratic Oath proscribed the use of abortifacients (substances or devices for inducing abortions), a prohibition respected by many physicians but ignored by others. The Hebrew and Christian scriptures do not denounce abortion and do not suggest that the fetus is a person. A passage in Exodus Chapter 21 touches on the topic and implies that the unborn entity is not a full human being. The passage comes after the emphatic "You shall not murder" of the Ten Commandments and after a warning that the penalty for murder is death. But Exodus 21:22 says that if a man causes a woman to have a miscarriage "but [she] is not harmed in any other way," the penalty is just a fine. Causing the death of a fetus was not considered murder. In Judaism, a fetus has immense worth as a potential human life, but it becomes a full human person only at birth. In Jewish law, abortions are allowed if the fetus threatens the life or health of the mother, but they are disallowed for fetuses with genetic imperfections. Some authorities say abortion is permitted up until birth even if the mother's life or health is not in jeopardy, if only to avoid the pain, anguish, or hardship that a birth would bring. Christians have generally condemned abortion, though their ideas about the personhood of the fetus have changed through the centuries. Many contemporary Christians, especially Roman Catholics, assume that the unborn is a full human being from the moment of conception. But in the twelfth century, the church came to the view that an embryo cannot have a soul until several weeks after conception. The rationale, inspired by Aristotle, was that the unborn cannot have a soul until it is "formed" - that is, until it has a human shape, a stage that is reached long after conception. Thomas Aquinas accepted this view and maintained that male embryos are formed (and thus given a soul, or "ensouled") 40 days after conception; female embryos, 90 days. Thus, killing a fetus, though always sinful, is not murder until after it is formed. In 1312, this doctrine became the church's official position. Only in the late nineteenth century did the church decide that ensoulment happens at conception and that any abortion after that point is the killing of a human person. ## Fact File: U.S. Abortions - Almost half (45 percent) of all pregnancies in 2011 were unintended. - About 40 percent of unintended pregnancies (not including miscarriages) ended in abortions. - In 2014, about 926,200 abortions were performed, down 12 percent from 1.06 million in 2011. Among women aged 15-44, 1.5 percent had an abortion. - In 2014, the abortion rate was 14.6 abortions per 1,000 women aged 15-44. This is the lowest rate ever documented in the United States. The rate in 1973, when abortion became legal, was 16.3. - At the rate of 14.6 abortions per 1,000 women, 5 percent of women will have an abortion by age 20, 19 percent by age 30, and 24 percent by age 45. - In 2014, 12 percent of abortion patients were adolescents; 8 percent were aged 18-19. - In 2014, 39 percent of abortion procedures were obtained by White patients, 28 percent by Blacks, and 25 percent by Hispanics. - In 2014, 17 percent of abortion patients said they were Protestant, 13 percent evangelical Protestant, 24 percent Catholic, and 38 percent no religious affiliation. - In 2014, 51 percent of women who had abortions had used contraception during the month they became pregnant. - Fewer than 0.5 percent of women having first-trimester abortions suffer major complications requiring hospitalization. - First-trimester abortions pose virtually no long-term risks of infertility, ectopic pregnancy, miscarriage, or birth defects, and little or no risk of preterm or low-birth-rate deliveries. - In 2014, 31 percent of all nonhospital abortions were medication abortions. - The three most common reasons for having an abortion were (1) concern for or responsibility to other individuals; (2) not being able to afford raising a child; and (3) the belief that having a baby would interfere with work, school, or caring for dependents. - A 2016, five-year study of 1,000 women who sought abortions showed that those who had the procedure did not experience more mental health problems (depression, anxiety, dissatisfaction with life, low self-esteem) than women who were denied abortions. The research was published in JAMA Psychiatry and was thought to be the most rigorous study to date on the psychological impact of abortions.(M. Antonia Biggs, Ushma D. Upadhyay, Charles E. McCulloch, et al., "Women's Mental Health and Well-Being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study," JAMA Psychiatry 74, no. 2 (2017): 169–78, doi:10.1001/jamapsychiatry.2016.3478.) ## In Depth: Abortion and Public Opinion 2021 **Percentage of adults who say abortion should be legal/illegal:** - Legal in all or most cases: 59% - Illegal in all or most cases: 39% **Percentage of adults who say abortion should be legal/illegal, by religion:** | Religious affiliation | Legal in all/most cases | Illegal in all/most cases | |:-------------------------------------------|:----------------------|:-----------------------| | White evangelical Protestant | 21% | 77% | | Catholic | 55% | 43% | | Black Protestant | 64% | 33% | | White mainline Protestant | 63% | 37% | | Unaffiliated | 82% | 16% | **Percentage of adults who say abortion should be legal/illegal, by party identification:** | Party identification | Legal in all/most cases | Illegal in all/most cases | |:------------------------------------------|:----------------------|:-----------------------| | Republican/lean Rep. | 35% | 63% | | Democrat/lean Dem. | 80% | 19% | **Percentage of adults who say abortion should be legal/illegal, by education level:** | Level of education | Legal in all/most cases | Illegal in all/most cases | |:------------------------------------------|:----------------------|:-----------------------| | High school or less | 50% | 47% | | Some college | 61% | 38% | | College grad or more | 68% | 31% | *From Pew Research Center, "Public Opinion on Abortion," survey conducted April 5-11, 2021, Public Opinion on Abortion, Pew Research Center (pewforum.org).* Over half of women having abortions are under 25 years old, and almost one-fifth of these are teenagers. Fifty-seven percent of abortions are performed on women who have never married; 17 percent, on married women; and 16 percent, on women who are separated, divorced, or widowed. Their reasons for terminating a pregnancy are varied. According to a survey of women who had abortions, the reasons include: - Having a baby would change my life (interfere with education, employment, etc.). - 74 percent - I can't afford a baby now (I'm unmarried, unemployed, destitute, etc.). - 73 percent - I don't want to be a single mother, or I'm having relationship problems. - 48 percent - My relationship or marriage may break up soon. - 11 percent - I've already completed my childbearing. - 38 percent - My husband or partner wants me to have an abortion. - 14 percent - There are possible problems affecting the health of the fetus. - 13 percent - There are physical problems with my health. - 12 percent - I was a victim of rape. - 1 percent - I became pregnant as a result of incest. - less than 0.5 percent Polls gauging the attitudes of the American public toward abortion have revealed many divisions but also remarkable agreement on some points. Only a small minority of people (16 percent) think that abortion should be illegal or unavailable in all circumstances. Most reject a total ban but differ on the existence or extent of restrictions placed on abortion. Roughly half consider themselves to be "pro-life" and half "pro-choice." A sizable majority (69 percent) would not like to see Roe v. Wade completely overturned. ## The Legal Struggle As we have seen, abortion is both a moral and legal issue, and these two lines of debate must not be confused. But we cannot ignore how the legal conflict has influenced the ethical arguments, and vice versa. The former seized the attention of the nation when Roe v. Wade was handed down. Roe was “Jane Roe,” a.k.a. Norma McCorvey, who had sought a nontherapeutic abortion in Texas where she lived. But Texas law forbade all abortions except those necessary to save the mother's life. So Roe sued the state of Texas in federal court, which ruled that the law was unconstitutional. Texas appealed the decision to the U.S. Supreme Court, and the Court sided with the federal court, declaring in Roe v. Wade that no state can ban abortions performed before viability. The Court saw in the Constitution (most notably the Fourteenth Amendment, which grants due process and equal protection under the law) a guaranteed right of personal privacy that limits interference by the state in people's private lives, and the majority believed that the right encompassed a woman’s decision to terminate her pregnancy. But, the Court noted, “this right is not unqualified and must be considered against important state interests in regulation.” So it balanced the woman’s right and state interests according to trimester of pregnancy. In the first trimester, the woman’s right to end her pregnancy cannot be curtailed by the state. Her decision must be respected, and “its effectuation must be left to the medical judgment of the pregnant woman’s attending physician.” In the second trimester, the state may limit - but not entirely prohibit - the woman’s right by regulating abortion for the sake of her health. After viability, the state may regulate and even ban abortion except when it is necessary to preserve her life or health. The Court affirmed that its ruling “leaves the State free to place increasing restrictions on abortion as the period of pregnancy lengthens, so long as those restrictions are tailored to the recognized state interests.” The Court noted that the Constitution does not define “person” and that “the word ‘person,’ as used in the Fourteenth Amendment, does not include the unborn.” In fact, the law has never maintained that the unborn are persons “in the whole sense.” After this historic case, the Supreme Court handed down numerous other decisions that circumscribed, but did not invalidate, the right to abortion defined in Roe. In these rulings, the Court held that (1) a woman can be required to give her written informed consent to abortion, (2) the government is not obliged to use taxpayer money to fund abortion services, (3) parental consent or a judge’s authorization can be demanded of minors under age 18 who seek abortions, (4) a state can forbid the use of public facilities to perform abortions (except to save the woman’s life), (5) a woman who consents to an abortion can be required to wait 24 hours before the procedure is performed, (6) a state can mandate that a woman be given abortion information, and (7) states may not prohibit abortions necessary to preserve a woman’s life or health. Eventually the court came to a key doctrine concerning such limitations: Before viability, abortion can be restricted in many ways as long as the constraints do not amount to an “undue burden” on a woman trying to get an abortion. A state regulation constitutes an undue burden if it “has the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.” ## In Depth: Abortions Performed Later in Pregnancy Abortions performed after 21 weeks - often mislabeled “partial-birth,” “late-term,” or “post-viability” - are politically and morally controversial. Here are the facts outlined by a nonpartisan source. Abortions occurring at or after 21 weeks gestational age are rare. They are often difficult to obtain, as they are typically costly, time-intensive and only performed by a small subset of abortion providers. Yet these abortions receive a disproportionate amount of attention in the news, policy and the law, and discussions on this topic are often fraught with misinformation; for example, intense public discussions have been sparked after several policymakers have theorized about abortions occurring “moments before birth” or even “after birth.” In reality, these scenarios do not occur, nor are they legal, in the U.S. Members of the medical community have criticized the term “late-term” abortion, as it implies abortions are taking place after a pregnancy has reached “term” (37 weeks) or “late term” (>41 weeks) which is false. In fact, the American College of Obstetricians and Gynecologists (ACOG) has written that “late-term abortion” has no medical meaning and should not be used in clinical or legal settings. ## Why do People Have Abortions Later in Pregnancy? **Non-Medical Reasons:** Individuals seek abortions later in pregnancy for a number of reasons. As part of the Turnaway study out of the University of California San Francisco, from 2008-2010 over 440 women were asked about why they experienced delays in obtaining abortion care, if any. Almost half of individuals who obtained an abortion after 20 weeks did not suspect they were pregnant until later in pregnancy, and other barriers to care included lack of information about where to access an abortion, transportation difficulties, lack of insurance coverage and inability to pay for the procedure. This is unsurprising, given abortions can be cost-prohibitive for many. **Fetal Anomalies:** Individuals also seek abortions later in pregnancy due to medical reasons. With medical advances, many genetic fetal anomalies can be detected early in pregnancy; for example, chorionic villus sampling can diagnose Down Syndrome or cystic fibrosis as earlier as 10 weeks gestation. Structural fetal anomalies, however, are often detected much later in pregnancy. A proportion of these are lethal fetal anomalies, meaning that the fetus will almost certainly die before or shortly after birth. **Health Risk to the Pregnant Person:** Life-threatening conditions may also develop later in pregnancy. These include conditions like early severe preeclampsia, newly diagnosed cancer requiring prompt treatment, and intrauterine infection (chorioamnionitis) often in conjunction with premature rupture of the amniotic sac (PPROM). If these conditions arise before the fetus is viable, the pregnant individual may pursue termination of pregnancy to preserve their own health. *From KFF (Kaiser Family Foundation), "Abortions Later in Pregnancy," December 5, 2019, https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/* ## Does a Fetus Feel Pain? In recent years this question has been hotly debated, with the pro-life side insisting that fetuses can experience pain as early as 20 weeks after conception (22 weeks after last menstrual period), and the pro-choice side asserting that fetuses cannot perceive pain until much later, no earlier than 24 weeks. Fetal pain has become controversial because it is now being used in an anti-abortion argument that abortions causing fetal pain are obviously immoral and therefore should be stopped. So several states have enacted laws banning abortions after 20 weeks, and in 2015 the U.S. House of Representatives passed a bill that would ban them after 22 weeks. (Such laws would pertain to relatively few abortions, since 99 percent of abortions occur before 21 weeks.) Most scientists involved in this issue think fetal pain is probably not possible until after the time when most abortions take place. In 2005, a multidisciplinary analysis published in the Journal of the American Medical Association concluded that fetal perception of pain is unlikely before the third trimester, which begins at 27 weeks. In 2010, the British Royal College of Obstetricians and Gynaecologists said that fetuses cannot experience pain before 24 weeks. In 2012, the American Congress of Obstetricians and Gynecologists largely agreed with their British counterparts. These reports, however, are hardly the last word on the subject. Abortion opponents cite research they say suggests that fetuses are conscious of pain at 20 weeks. Some experts point to the complexity of the pain response and how little science understands about it. They say it's best to assume that fetal pain can occur early and adjust our actions and attitudes accordingly. ## Persons and Rights People generally take one of three positions on the moral permissibility of abortion. The conservative view is that abortion is never morally acceptable (except possibly to preserve the mother’s life), for the unborn is a human being in the full sense. The liberal view is that abortion is acceptable whenever the woman wants it, for the unborn is not a human being in the full sense. The moderate stance falls between these two stands, rejecting both the conservative’s zero-tolerance for abortion and the liberal’s idea of abortion on request. For the moderate, some - but not all - abortions may be morally justified. (These labels are common but sometimes misleading; being a conservative or liberal on the abortion issue does not necessarily mean you are a conservative or liberal in the broader political sense.) Despite appearances, between the conservatives and the liberals there is at least a patch of common ground. Both sides agree on some basic moral principles - for example, that murder is wrong, that persons have a right to life, and that personal freedom should not be curtailed except for very important reasons. Conflicts arise not over such fundamentals but over the nonmoral facts (such as the nature of the fetus) and over the meaning and application of moral standards. The main conservative argument against abortion is straightforward and based on a widely shared intuition about the wrongness of killing innocents. One popular formulation says that (1) the killing of an innocent human being is wrong; (2) the unborn is an innocent human being; (3) therefore, it is wrong to kill the unborn (abortion is immoral). At first glance, this argument may seem sound, but critics point out that the term human being improperly switches meanings in mid-argument, invalidating the inference (and thus committing what is known as the fallacy of equivocation). The problem is that in premise 2, human being means an entity that is biologically human, a member of the genetically distinct human species. But in premise 1, human being refers to an entity having all the psychological attributes and capacities that we normally associate with the possession of full moral rights (including a right to life) - what philosophers call a person. If human being referred to the same thing throughout the argument, the argument would be valid. But the argument equivocates on the term and is therefore invalid. The conservative, however, avoids these difficulties by offering an improved version of the argument: (1) The killing of an innocent person is wrong; (2) the unborn is an innocent person from the moment of conception; (3) therefore, it is wrong to kill the unborn (abortion is immoral). This argument is valid, and premise 1 is obviously true. The crux of the matter is premise 2, which the conservative asserts and the liberal denies. What arguments can the conservative offer to support it? One option is to start with this observation: In the continuous process of development from zygote to adult human, there seems to be no precise point at which the entity becomes unmistakably a bona fide human being (with a right to life). No clear line between nonperson and person can be found. Any point we select to indicate the nonperson/person boundary would be arbitrary and unsupportable. The conservative argues that the most plausible view then would be that personhood (and the right to life) begins at conception. It is at conception that, for example, a full complement of genetic information is present to propel development of a completely formed, mature human. As one philosopher puts it, "The positive argument for conception as the decision moment of humanization is that at conception the new being receives the genetic code. It is this genetic information which determines his characteristics, which is the biological carrier of the possibility of human wisdom, which makes him a self-evolving being. A being with a human genetic code is man." Critics respond in various ways to this view. They point out, for example, that just because no nonperson/person line can be drawn doesn’t mean there is no difference to be observed between the two phenomena. We may not be able to specify the precise moment when a tadpole turns into a frog, but we know there is a real difference between the two states. The failure to pinpoint a distinct moment when the unborn becomes a person does not show that it must be a person from the moment of conception. Some philosophers argue on empirical grounds that the zygote cannot be an individual human being: “[T]he very early conceptus cannot be identified with the embryo that may develop from it. This is because, for about the first two weeks of existence, it consists of a set of undifferentiated cells, any one of which could give rise to an embryo under certain circumstances. This “pre-embryo” may spontaneously divide, resulting in twins or triplets; alternatively, it may combine with another pre-embryo, giving rise to a single fetus.” The liberal tack is to identify these traits and point out that a fetus does not possess them. According to Louis Pojman, “These properties are intrinsically valuable traits that allow us to view ourselves as selves with plans and projects over time, properties like self-consciousness and rationality. Although it is difficult to specify exactly what are the necessary and sufficient conditions for personhood, and liberals have described these conditions differently - some emphasizing desires and interests, others emphasizing agency or the ability to project into the future, others emphasizing the capacity for a notion of the self - they all point to a cluster of characteristics which distinguish children and adults from fetuses, infants, and most animals." Mary Anne Warren famously identifies five traits that are “most central” to personhood: (1) consciousness and the capacity to feel pain, (2) reasoning, (3) self-motivated activity, (4) the capacity to communicate, and (5) “the presence of self-concepts, and self-awareness, either individual or racial or both.” To be considered a person, she says, a being need not possess all these traits, but surely “any being which satisfies none of (1)-(5) is certainly not a person.” A fetus in fact satisfies none and is therefore not yet a person and “cannot coherently be said to have full moral rights.” The conservative will counter that the liberal’s standards for personhood are set too high, for they imply that cognitively impaired individuals - victims of serious dementia, intellectual disability, or schizophrenia, for instance - are not persons and therefore do not have a right to life. The liberal view seems to condone the killing of these unfortunates, a repugnant implication. The liberal response is that even if cognitively impaired individuals do not qualify as persons, we may still have good reasons for not killing them - for example, because people value them or because a policy allowing them to be killed would be harmful to society (perhaps encouraging unnecessary killings or causing a general devaluing of life). In addition, the liberal points out that the personhood status of many (or most) cognitively impaired individuals is unclear, so a policy of regarding them as less than persons would be risky. The biggest challenge to the liberal notion of personhood is the charge that it sanctions infanticide. The argument is that if killing a fetus is morally permissible because it is not a person, then killing an infant must be acceptable as well, for it is not a person either. According to the liberal’s personhood criteria mentioned earlier, neither a fetus nor an infant is a person. Moreover, there is a glaring problem with the common liberal assumption that birth is the point at which a fetus becomes a person: The fetus just before birth and the infant just after are biologically almost indistinguishable. Saying that the former has no right to life but the latter does seems hard to justify. Liberals contend that even if infants are not persons, infanticide is rarely permissible (possible exceptions include cases of horrendous birth defects and terminal illness). Some (including Warren) say that this is so because infants, though not persons, do have some moral standing. For example: "In this country, and in this period of history, the deliberate killing of viable newborns is virtually never justified. This is in part because neonates are so very close to being persons that to kill them requires a very strong moral justification—as does the killing of dolphins, whales, chimpanzees, and other highly personlike creatures. It is certainly wrong to kill such beings just for the sake of convenience, or financial profit, or "sport." Others say that infanticide is to be condemned for reasons of social utility. As Joel Feinberg explains, “The moral rule that condemns these killings [infanticide] and the legal rule that renders them punishable are both supported by "utilitarian reasons," that is, considerations of what is called "social utility," "the common good," "the public interest," and the like. Nature has apparently implanted in us an instructive tenderness toward infants that has proven extremely useful to the species, not only because it leads us to protect our young from death, and thus keep our population up, but also because infants usually grow into adults, and in Benn's words, "if as infants they are not treated with some minimal degree of tenderness and consideration, they will suffer for it later, as persons." One might add that when they are adults, others will suffer for it, too, at their hands. Spontaneous warmth and sympathy toward babies then clearly has a great deal of social utility, and insofar as infanticide would tend to weaken that socially valuable response, it is, on utilitarian grounds, morally wrong.” ## Moderate Views Moderate views on abortion can be sketched out in a variety of ways. Many moderates claim the middle ground by arguing that the fetus achieves personhood at a point somewhere between conception and birth — at viability, at the time when fetal brain waves occur, or at some other notable point. Other moderates reject the notion of a distinct developmental line separating persons from nonpersons. They argue instead that the moral standing or right to life of the fetus increases gradually as it develops (expanding from minimal rights to almost full rights, for example) or that there is an indistinct threshold stage (when sentience emerges, say) beyond which the fetus has significantly increased moral standing. Departing dramatically from these strategies, some moderates stake out their position without appealing to fetal personhood. The most famous example of the latter comes from Judith Jarvis Thomson. She argues that even if the conservative view is correct that the unborn is a person from the moment of conception, abortion may still be morally justified. A fetus may have a right to life, but this right “does not guarantee having either a right to be given the use of or a right to be allowed continued use of another person’s body - even if one needs it for life itself.” The unborn’s right to life is not absolute. It implies not that killing a fetus is always wrong, but that killing it unjustly is always wrong. Thomson argues her point with this striking analogy: "You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist’s circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, “Look, we’re sorry the Society of Music Lovers did this to you - we would never have permitted it if we had known. But still, they did it, and the violinist now is plugged into you. To unplug you would be to kill him. But never mind, it’s only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you.” Thomson believes that our intuitions would tell us that this arrangement is outrageous, that the violinist’s right to life would not give him the right to exploit someone’s body against her will. Analogously, a fetus’s right to life would not guarantee it unauthorized use of the mother’s body; the mother has a right of self-defense. Abortion, therefore, is justified when the fetus takes up residence without the woman’s consent, as when pregnancy is due to rape or failed contraception. Some reject Thomson’s argument by contending that it holds only if the woman bears no responsibility for her predicament, if the attached violinist or fetus takes up residence through no fault of her own. She may not be responsible for the fetus if she becomes pregnant through rape; she does not, after all, consent to be raped. But she can be held responsible if she voluntarily engages in sexual intercourse; she therefore is obligated to carry the fetus to term. Others maintain that the woman is obliged to sustain the life of the unborn because she has a filial obligation to it. The unborn has a natural claim to the woman’s body. "You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist’s circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, “Look, we’re sorry the Society of Music Lovers did this to you - we would never have permitted it if we had known. But still, they did it, and the violinist now is plugged into you. To unplug you would be to kill him. But never mind, it’s only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you.” Thomson believes that our intuitions would tell us that this arrangement is outrageous, that the violinist’s right to life would not give him the right to exploit someone’s body against her will. Analogously, a fetus’s right to life would not guarantee it unauthorized use of the mother’s body; the mother has a right of self-defense. Abortion, therefore, is justified when the fetus takes up residence without the woman’s consent, as when pregnancy is due to rape or failed contraception. Some reject Thomson’s argument by contending that it holds only if the woman bears no responsibility for her predicament, if the attached violinist or fetus takes up residence through no fault of her own. She may not be responsible for the fetus if she becomes pregnant through rape; she does not, after all, consent to be raped. But she can be held responsible if she voluntarily engages in sexual intercourse; she therefore is obligated to carry the fetus to term. Others maintain that the woman is obliged to sustain the life of the unborn because she has a filial obligation to it. The unborn has a natural claim to the woman’s body.