Christians are expected to be “speaking the truth in love” (Eph. 4:15a RSV), for, as Jesus told them, “the truth will make you free.” (Jn. 8:32n RSV). Truth is important. Freedom can only be protected if we are willing to embrace the truth. But finding the truth is not always easy, and often, all we have is a partial understanding of, leading us to be in conflict with others with their own partial understanding of it. This is why truth must always me engaged with love, indeed, with love as the foundation which we use to engage the world. Then we will realize how difficult moral questions can be; ignoring that complexity requires us to either hide some element of the truth, or worse, lie about it, in order to keep things simple. Not being honest with others will only make things worse, especially as the more we prove ourselves untrustworthy. the less willing people will be to dialogue with us and engage our viewpoints. What is worse, if we hide the truth from ourselves, ideology quickly steps in to engage us where we are at, using our lack of truth as a means to enforce its interest (which, of course, is not the truth) upon everyone, using whatever means it finds possible to do so. And as the truth has been lost, the ideology is not going to promote the common good, but rather, a particular application of the good, a lesser good, which will result, as with all such applications, in the promotion or production of some evil in the world.
This is exactly what we see happening in the debate over abortion in the United States.[1] So-called pro-life leaders tend to ignore, or outright misrepresent, the issues. Recently, many pro-life writers have tried to redefine the meaning of the word abortion, suggesting only one kind of abortion, so-called “elective abortion,” as being what the word means. They do this as a way to suggest any concern that people have concerning laws which outlaw abortion are not properly founded because they say that if a woman were to terminate their pregnancy due to health reasons, that would not be an abortion, and so no action would be taken against them or their doctors. While it is true that moral theology talks about the errors behind many forms of “elective abortion,” and uses that to discuss the evils behind abortion, the fact that we have to distinguish “elective” abortions from other kinds indicate there are many other kinds of abortion than elective abortion. Thus, it would be disingenuous to use discussions on the problems surrounding “elective” abortions as providing a definition for the general term of abortion.
Sadly, even when texts are written with the proper understanding of the moral principles involved, the way they do so can make it difficult for the average reader to understand whether or not they are providing a definition of abortion. This has happened with the USCCB’s Ethical and Religious Directives For Catholic Health Care Services; when it talks about abortion, it makes it clear that it is rejecting what is often called “elective abortion,” but it does so in such a way that some might think it is defining what an abortion is, when it is not: “Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.” [2] This is not what an abortion is. If read as a definition, it gets the definition wrong; rather, we should understand what is found in the parenthesis to be a description of the kind of abortion under moral consideration. Sadly, however, many want to use it as the definition for abortion, ignoring, therefore, the definitions which are used in law and medicine. [3] However, it is clear, that text is merely interested in “elective abortions,” for it also says:
Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.[4]
The documents main concern in regards abortion is to give a basic explanation for the Catholic moral position on abortion. But it is important for us to realize that abortion is medical procedure, and thus, it is best that we look to medicine for its definition (and not a general discussion concerning the moral implications of abortion). An abortion is any early termination of a pregnancy, whether or not it was intended or not, induced or accidental:
In medicine, an abortion is a loss of pregnancy due to the premature exit of the products of conception (the fetus, fetal membranes, and placenta) from the uterus due to any cause. An abortion may occur spontaneously (termed a miscarriage) or may be medically induced. [5]
Miscarriages have traditionally been designated as an abortion, and only in the 20th century, was the term miscarriage developed as an alternative word to use to help deal with moral, legal, and technical distinctions between miscarriages and other kinds of abortions. The medical definition of abortion is important because it is what doctors use when discussing their procedures, and it is what the legal system will have to use if no other definition is explicitly given when a law is made to prohibit abortion. Instead of assuming laws which ban abortion only ban those which some people think are morally indefensible, laws tend to be rather vague as to what is and what is not permitted, that is, under what exceptions (if any) an abortion is to be permitted. [6] This is why many doctors are concerned with the way things have changed since the Supreme Court has said the states can regulate abortion; they know the laws already written, and others which will be written, will be vague in relation to what is permitted, if any exception is made to allow some kinds of abortion. They know legislatures are unlikely to understand or know about the variety of medical procedures available, mor when or why such procedures are used; due to such ignorance, doctors rightfully fear laws put in place which will be founded upon false premises. They also know, by the way many pro-life activists act, pro-life lawmakers have not shown much of any concern about the welfare of the women involved, which is why they are not working with doctors to make sure their laws do no harm to the women involved. Doctors are also afraid, and rightly so, that even if some legislatures try to establish exceptions which will allow various kinds of abortions in theory, in practice those exceptions will be consistently tested by prosecutors. And, as their fears have been justified, as we see this already happening, as can be seen in Indiana, where the Attorney General has specifically said he will try to find a way to punish the doctor who helped a ten year old rape victim by giving her an abortion, despite the doctor’s medical indication that the embryo was not viable, and the rape victim’s health and life were in jeopardy. Similarly, even though Catholic moral theology has found ways to allow some forms of abortion (those directly intended, and done for the sake of the health of the woman involved) through the application of double effect, those who have done the calculus to save a mother’s life, through the proper application of double effect, Catholics find they are liable to be punished by some in the hierarchy if they follow through with Catholic teaching, as we can see in the case of Sister Margaret McBride, who experienced a brief excommunication because of the way she approved a life-saving procedure for a pregnant woman which resulted in an abortion:
The surgery took place in late 2009 as the patient’s condition worsened. She had a rare and often fatal condition called pulmonary hypertension in which a pregnancy can make things much worse. She was 11 weeks pregnant, according to a statement from the hospital.[7]
Many wanted Sister McBride to be removed from her position at the hospital as well as from her religious order, but in the end, her excommunication was lifted, and she was able to return to her work. Some might think, if the excommunication was lifted, why should there be a problem? The answer is obvious. It shows that even though Catholic moral theology is applied and shows the action was justified, the sister was still criticized and treated with contempt, suggesting that, when dealing with abortion, moral reflections, even by those in positions of authority, tend to be ideological and legalistic instead of holistic and embracing the fullness of Catholic moral principles. If that is done within Catholicism, it will be even worse in secular society. For if such moral reasoning is not enforced by those who know better, it will likewise be ignored by those who do not know and understand them, so that those who are participate in an abortion, even if it is one justified via double effect, will find themselves, their career, indeed, their freedom in jeopardy. This is why many doctors are frightened, for they know many prosecutors are looking for any excuse to punish them, and as a result, many of them are not performing needful operations, or waiting to the last minute to do them, making the dire for their patients. We know this because we can find many situations where this is happening, such as a now often talked about case in Texas where a woman who suffered a miscarriage had difficulty getting the treatment she needed:
Stell and her husband were heartbroken by the news, especially so when she asked her doctor to perform a dilation and curettage, better known as a D&C, which removes pregnancy tissue from the uterus. Stell said her doctor refused due to Texas’ anti-abortion law.
The D&C is the same procedure to remove a living fetus. Even though Stell suffered a miscarriage and did not have a living fetus inside her, she was denied medical care until she had additional ultrasounds proving that she had a miscarriage.[8]
This is not an isolated case. It continues to be a real threat around the United States, as can be seen with the way clinics in Wisconsin are not giving proper medical care to women suffering from miscarriages because of fear of what government officials will do to them:
In Wisconsin, for example, some clinics already are refusing to use mifepristone to help women pass an early miscarriage because the drug also can be used in medical abortions, said Dr. Amy Domeyer-Klenske, an OB-GYN in Milwaukee who is vice chair of the Wisconsin chapter of the American College of Obstetricians and Gynecologists. [9]
Doctors know the definition of abortion; they know it can and will be used against them, if they are shown to directly or indirectly be connected to an abortion, and someone in a position of power and authority wanted to make an example out of them to detour anyone from performing an abortion. This is not theoretical. It’s what is happening now. What we see coming out of Indiana shows that these threats are real, and some anti-abortion lawmakers and attorneys are looking for any excuse to exercise their authority and punish those involved with abortion, whether or not legally speaking, such abortion was permissible. Even laws which seem to help doctors do not protect them as intended, because there are many questions which arise when one looks at them. Laws written to suggest that an abortion is permitted when a woman’s life is threatened still leave many questions unanswered:
Nothing in these laws specifically outlines what constitutes life-endangering or how “serious” a circumstance must be in order intervene. For physicians, who can now be fired and sued for “aiding and abetting” an unlawful abortion, this ambiguity may be determinant: Not only could it dissuade a person from performing an abortion, but also it could delay them performing one; for instance, while hospital attorneys or even government officials are consulted to determine the legality of the procedure. Simply speaking, this transgresses nearly every basic medical ethics principle — namely autonomy, nonmaleficence, beneficence, and justice — with a pregnant person’s life hanging in the balance. [10]
And, as Michele DeMarco further explained, many of the bills or laws think a medical necessity can be acceptable only if there is an immediate need for the abortion, which, not only is difficult to determine, but risks making a woman’s health deteriorate, potentially leaving them with long-term, if not life-long, harmful after effects:
Second, consider the language “medical emergencies,” which is increasingly being used both in law and common parlance. Mississippi’s contentious abortion law defines medical emergencies as “a condition that in the physician’s good-faith medical judgment, based upon the facts known to the physician at that time, so endangers the life of the pregnant woman or a major bodily function of the pregnant woman as to necessitate the immediate performance or inducement of an abortion.” The problem is that not all conditions that threaten a pregnant person’s life are active emergencies when they are known, treated, and managed — as my own situation shows. [11]
Finally, it is clear, pro-life activists have not shown any care or concern with the ramifications of the laws they want to put in place. They do not care about the livelihoods of the women and doctors involved. They do not want to really consider abortion will ever be deemed necessary (even if it is done to the satisfaction of traditional moral considerations, such as that the abortion is not directly intended but merely the accident of another, directly intended action done to save the life of the woman involved). Thus, while it has been shown social safety nets help eliminate the need for abortion, many of those activists have long fought against those same safety nets, and are not working to promote them now:
But research suggests some of those plans are unlikely to provide an effective safety net for low-income women and children, and it’s unclear how much support will materialize for any proposed federal legislation given Republican leaders’ opposition to funding federal paid leave, extending child tax credits and expanding maternal health care.[12]
This calls into question how much love and compassion is given out by those who oppose abortion. They should be extremely concerned about the social safety net, but the fact that they not only have not shown such concern, but have often worked against them, shows their concern is not truth in love but rather, something else, something far darker and sinister (which is easily apparent in the way they want to penalize even those they claim could have legal and moral justifications for administering an abortion). If anti-abortion polemics has no basis or concern with love, they already depart from the greater good. This is why it should not be surprising that many of them want to hide the fullness of the truth from the public by attempting to redefine the meaning of abortion; then they can use that redefinition to say that medically necessary abortions are impossible. While they will speak out in such a way before such an abortion happens, how many of them will speak up and defend doctors and women if they are being investigated or charged with a crime, for an action they claim is not really an abortion? They are at best silent in that regard, if not actively supporting such prosecution themselves, showing they know full well that the issue at hand. They know few people would accept the blanket rejection of abortion they want to establish by anti-abortion legislation, and so they try to hide what is going on by saying those abortions which would be exceptions would not be prosecuted because they would not really be considered abortions. Such dishonesty in tactics, combined with the lack of love and compassion for those involved with such abortions, demonstrates how far they are from the truth and love expected from Christians. They actively play the defense for an ideology instead of accepting and discussing all the difficulties involved with abortion. Christians must do better. They must be willing to admit the truth, and that includes, the difficulties around the issue of abortion, recognizing that not all abortions are the same. They should show that the truth they believe does not undermine their witness in the world as people concerned about truth founded upon and love. Until they do so, more and more people will reject them and what they have to say because they not only prove themselves be dishonest dialogue partners, but they prove to be dangerous ideologues whose vision of justice is itself unjust and tyrannical.
[1] While it should not be necessary, it is important to note that I agree with the proper, and careful, moral examination in relation to abortion found in Catholic moral theology (which is not exactly the same as the popular understanding many Catholics have concerning the issue). Thus, when moral theology describes many forms of abortion as being impermissible, I agree, they should not be done. However, the prudential application of such a moral concern in a secular society is not so easy to establish, as is the case with many Catholic moral principles. Aquinas made it clear we must be careful when we make laws, we should realize not all our principles can be or should be reflect in the law, for often when we try to do so, that only makes the situation worse. In such an instance, no law should be made. When a politician comes to this conclusion, we must confuse their view as if they are supporting that which they do not want to criminalize, for, if the argument used to suggest this is taken to its proper conclusion, God would be deemed a criminal because God permits all kinds of evil in the world. Aquinas, of course, understood this, which is why he believed prostitution should be permitted in society even if he opposed its practice
[2] United States Conference of Catholic Bishops, “Ethical and Religious Directives For Catholic Health Care Services. 6th Edition” (Washington, DC: United States Conference of Catholic Bishops, 2020), 18.
[3] See Katie Yoder, “Is Abortion Ever Allowed for Catholics? For a 10-Year-Old Rape Victim?” In National Catholic Register (7-15-2022).
[4] United States Conference of Catholic Bishops, “Ethical and Religious Directives For Catholic Health Care Services. 6th Edition”, 18.
[5] Jay W. Marks, MD, ed., “Medical Definition Of Abortion” on MedicineNet (6-3-2021).
[6] See Mark Kekatos, “Why Doctors Say The ‘Save The Mother’s Life’ Exception Of Abortion Bans Is Medically Risky” in ABCNews (6-13-2022).
[7] Michael Clancy, “Nun Excommunicated For Allowing Abortion” in National Catholic Reporter (5-18-2010).
[8] Sarah Martinez, “Texas Woman Shares Story Of Carrying Dead Fetus Due To Anti-Abortion Laws” in MySA (7-19-2022).
[9] Michael Ollove, “Critics Fear Abortion Bans Could Jeopardize Health of Pregnant Women” in PEW (6-22-2022).
[10] Michele DeMarco, “The New Abortion Restriction No One is Talking About” in Politico (4-28-2022).
[11] Michele DeMarco, “The New Abortion Restriction No One is Talking About.”
[12] Julianne McShane, “Anti-abortion Groups That Worked To Overturn Roe Have No Unified Strategy To Help Women And Children” in NBCNews (7-19-2022).
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