Mirror of Justice

A blog dedicated to the development of Catholic legal theory.
Affiliated with the Program on Church, State & Society at Notre Dame Law School.

Thursday, August 18, 2011

The Real Test of Pro-Choice Honesty

Jennifer Fulwiler comments on the same article in the NYT Magazine that Rob Vischer blogged about here at MOJ.  The Times article, The Two-Minus-One Pregnancy, is about couples who conceive twins through IVF and then (in the Orwellian terminology of the industry) “selectively reduce” the twins so that only a single gestating baby remains.  As the article makes clear, while it used to be the case that the procedure was reserved for “reducing” quadruplets (or more) to triplets, or triplets to twins, the practice has now become commonplace among IVF patients who do not want to give birth to anything other than a single child.

In her essay, What Pro-Choice Intellectual Honesty Looks Like, Fulwiler notes how some like Dr. Mark Evans, who pioneered the procedure and who once resisted performing it in the case of twins, came to understand that the women coming to see him “didn’t want to be in their 60s worrying about two tempestuous teenagers or two college-tuition bills” and that “many of the women were in second marriages, and while they wanted to create a child with the new spouse, they did not want two.”  Thus, she also notes how the new, more frequent use of the procedure in reducing twins to a singleton has little if anything to do with “health” – either with respect to the mother or the children she is carrying – and everything to do with life-style choices and expectations.

At the same time, and as the Times article makes clear, some physicians and medical staff who dutifully performed “reductions” in the case of quadruplets and triplets, refuse to do so in the case of twins on moral grounds since, according to Dr. Ronald Wapner, “There’s no medical justification in a normal twin pregnancy to reduce to one.”

Of course selectively practicing selective reduction makes no sense given the logic of the right to choose abortion.  There is no such thing as a sound or unsound reason, a better or worse motivation in the face of inviolable autonomy.  All reasons wither and fall before a “choice” that is its own justification.

Fulwiler concludes the post by thanking those women who agreed to tell their stories, and with the hope that pro-choice people will 

read those articles linked above, and listen to the stories of women going to abortion specialists and choosing sons over daughters, letting lifestyle considerations lead them to reduce three heartbeats on a screen to one. Because that is what pro-choice intellectual honesty looks like.

Although she doesn’t address it in the essay, I think that an even greater test of pro-choice honesty, intellectual or otherwise, will come when the truth about the woman’s pregnancy comes out and she must explain her actions to her children – to the older siblings that the couple may already have and to the surviving twin.  What will they tell these children?  What will a couple who has “selectively reduced” a pregnancy tell their children about what they chose to do to their sibling – their brother or sister in the womb – and why?

Given the views expressed by the different couples in the article, it is difficult to believe that they will not try to exonerate their chosen course of conduct, indeed, to portray it as virtuous, as the only reasonable alternative, as the only sensible and loving choice a responsible parent could have made.  This may be achieved by celebrating “choice” and glossing over the thing chosen.  As one mother who “reduced” her triplets to a single child says in the Times article, she “intends to tell her [now two-and-a-half year old daughter] about the reduction someday, to teach her that women have choices, even if they’re sometimes difficult.”

The doctors who perform “reductions” are partners in this process of exoneration.  As the Times article notes:

The doctors who do reductions sometimes sense their patients’ unease, and they work to assuage it. “I do spend quite a bit of time going through the medical risks of twins with them, because it takes away a little bit of the guilt they feel,” says Stone, the Mount Sinai doctor.

When the issue does arise the couple may mouth reasons already rehearsed in the article.  They may say that they did it out of love for them – for the older siblings and the surviving twin – so that they could afford to send them to college, so that they could spend more time with them growing up.  The fact that love is not a commodity – the central point of Rob’s post – may not resonate with them at so young an age, but they will come to appreciate it in time, causing them to doubt the wisdom of what was chosen – perhaps around the same time that the full worth and weight of the college tuition check Dad just cut hits home.

What is certain is that in explaining their actions to their kids, the couple who selectively aborts will not refer to their children as commodities or to the process of having children in the same crass terms of market and production articulated in the Times piece:

We created this child in such an artificial manner – in a test tube, choosing an egg donor, having an embryo placed in me – somehow, making  a decision about how many to carry seemed to be just another choice.  The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.

That is, in talking to the reporter from the Times, these parents may feel free to be candid and so describe their children as commodities – to see them as things that are produced like widgets.  Nevertheless, they will not refer to their children as things when they look the widget in the eye in explaining their own birth and the “selective reduction” they survived.

Parents who selectively “reduce” may even deny that any “twin” was lost at all (N.B. “Lost,” as if it was only a set of car keys that had been misplaced and not a human being deliberately destroyed).  That is, they may insist that it was merely a clump of tissue that they chose to safely discard.  Given the curiosity of most children this excuse will likely be unavailing, leading as it does to the retort “But Mom, wasn’t I a clump of tissue too?”  And the reply “Oh, Honey, you were different!” will – if real honesty is brought to the table – lead to an uncomfortable exchange unveiling to these children the perilous nature of their own existence at the hands of those whom they love and trust the most.

Wesley Smith captures this point well in his commentary on the Times piece (available here).  There he recalls the first time he heard of the procedure at a bioethics conference and his response to both the euphemism “selective reduction” and to the claim that the procedure can be used to “reduce” triplets to twins:

“Selective reduction doesn’t turn triplets into ‘twins,’” I said.  “It kills one of the three siblings.  The remaining two are still triplets, only one is dead.  And if they ever find out, they will know that but for the luck of where the abortionist chose to put his tools, they might never have been born.”

Moreover, even if the surviving children are misled so as to spare their parents the indignation of being judged murders by their own offspring, as time passes the parental obfuscations of childhood will give way to the chilling reality revealed by the time the siblings enter their high school biology class (assuming of course that schools are still permitted to teach the inconvenient facts of science by the time these children reach adolescence).

All of this can be contrasted with another situation that calls for honesty but one that involves a very different choice.  This is the honesty that is called for when a child who is adopted by another family asks his or her birthmother “Why was I placed for adoption?”  A more direct way of posing the question is “Why did you place me for adoption?”  And behind this question other questions and suspicions of their standing in the world are lurking and begging for some response: “Why was I abandoned?” “Did you reject me?”

I know, both from my own experience with adoption and the experience of friends and family who are also adoptive parents, that situations can vary.  So honesty may require a somewhat different response in different circumstances.  But today, in a cultural setting that celebrates autonomy – including the autonomy to choose death for another – the honest answer of most birthmothers is “No, I did not reject you.  I love you, and I decided that the best and fullest expression of that love was to place you for adoption.”

The practical concerns that led to such a placement decision may have been quite similar to those of women who “selectively reduce” – a lack of familial or financial resources, the interruption of life plans and the frustration of expectations.  But, in the case of adoption, the birthmother responded to these circumstances with genuine honesty – an honesty that reflects both the truth of human life and the truth of human love.


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Excellent post and comment, John. Thank you!

Posted by: Jonathan | Aug 18, 2011 2:32:14 PM

John, you write: "Given the views expressed by the different couples in the article, it is difficult to believe that they will not try to exonerate their chosen course of conduct, indeed, to portray it as virtuous, as the only reasonable alternative ...."

The decision to kill (abort, selectively reduce, whatever ...) has long struck me as one rooted in fear and selfishness, or some combination thereof. We all experience fear and selfishness, and all of us act out of such bad places, as well. And we're all pretty good at lying to ourselves, and others, that, "oh no, we weren't really acting out of fear or selfishness [b/c we're not fearful, selfish people, after all], but rather acting out of [insert whatever plausible sounding but not too self-damning explanation you can craft]."

Posted by: A reader | Aug 18, 2011 2:47:02 PM

I was discussing this article with someone whom I would describe as not merely staunchly pro-choice but staunchly pro-abortion, and after about ten minutes of grappling with the issues, he said, "You know, I'm beginning to think I oppose abortion." Pregnancy "reduction" does raise some very difficult questions. One issue it does not raise, as far as I am concerned, is the issue of euphemisms. One should not expect medical terminology to be anything but clinical. Don't expect doctors to say "chop off" instead of "amputate," or "slice open" instead of "make an incision," or "shove a camera ____ _____ _____" instead of "perform a colonoscopy."

Before I had emergency eye surgery once, my doctor said he would explain the procedure to me, and I said, "Please don't. Just do it." Now I know exactly what was done, but if I had told him to go ahead and explain it, and he had done so in nonclinical terms, I would have been freaked out. Depending on when one believes life begins, "selectively reducing twins to a singleton" may be "killing (or murdering) one twin and sparing the other," but in a clinical setting, nobody talks like that, nor should they be expected to.

Posted by: David Nickol | Aug 18, 2011 4:13:22 PM

Thank you, John. I wonder if those involved with the "selective reduction" procedure think about what they are taking out and what they are leaving in place? I wonder if they think that what--who--is removed is the same or different frome what--who--is left in place? I wonder if those involved with the procedure think about what would happen if the "selective reduction" were not performed (besides the reasons given in the NYT article)? These questions are not onerous ones to contemplate and address. RJA sj

Posted by: Robert John Araujo, S.J. | Aug 18, 2011 5:09:55 PM

William Saletan deftly captures the queasiness that he and some others who are pro-choice are feeling about the selective reduction issue. Definitely an interesting read at Slate: http://www.slate.com/id/2301322/

Posted by: Bill Collier | Aug 18, 2011 11:46:39 PM

David N.--

While true that doctors don't use euphemisms when speaking to most patients, as someone who has had a lot of experience working in hospitals, I can assure you that euphemisms abound when health care professionals talk among themselves.

Posted by: Bill Collier | Aug 18, 2011 11:52:18 PM

Much attention is now bing focused on the eugenic nature of abortion and "reduction", but so far there there is surprisingly little notice given to the manufacturing of babies in labs and rented wombs using genetic materials purchased or procured from "quality stock" (think of the ads seeking to purchase eggs from Ivy League co-eds for $10,000). Millions of babies have been (and are being) created in fertiliity clinics for same-sex couples and unmarried women who select sperm from a catalogue of donors whose physical characteristics seem suitable to the desires of the customers, and who have been screened for disease. The perfect product can be ready at the most convenient time. The "Octomom" and Elton John are just a couple of well-known examples, but it's an increasingly common, legal and even celebrated choice among middle-class communities. Children as commodities, genetic material in commercial transactions.




Posted by: Amelia | Aug 19, 2011 10:08:08 AM

What if one could select for death only children who would grow up to be atheists or liberals? Would abortion then be wrong?

Posted by: Fr. J | Aug 19, 2011 10:41:19 AM

John - thank you. Sadly, IVF often results in a lot more "reductions" in human life than the reduction of going from 3 children to 2, or 2 children to 1. In each IVF cycle many human lives are created and destroyed.

There are more effective (and much cheaper)natural solutions to infertilty than IVF. Please share this information with your friends: http://www.fertilitycare.org/

Posted by: BMoney | Aug 19, 2011 2:19:23 PM

Fr. J asks: "What if one could select for death only children who would grow up to be atheists or liberals? Would abortion then be wrong?"

Well, in the case of ectopic pregnancy, the Church prohibited medical intervention for decades until Bouscaren came up with a rationale for permitting a salpingectomy. If there were a way to get rid of atheists or liberals (I don't know why gay people were omitted here), I am sure some rationale could be worked out.

Posted by: David Nickol | Aug 19, 2011 3:40:38 PM

David, in some places they eliminate girls and don't you think if a "gay gene" is someday isolated that some parents would abort that child? Or would you then start to argue against abortion?

Posted by: Fr. J | Aug 19, 2011 5:46:30 PM

Fr. J,

I am perfectly willing to argue against abortion for sex selection, abortion to eliminate babies with Down syndrome, abortion in just about any circumstance, "selective reduction" of twins, and quite a lot of other things being practiced nowadays.

Posted by: David Nickol | Aug 19, 2011 10:06:33 PM

David, so you are unequivocally pro-life and agree unreservedly with the Church's teaching on abortion i.e. that direct abortion is never acceptable?

Posted by: Fr. J | Aug 20, 2011 2:44:58 PM

Fr. J--

There are plenty of areas where I disagree with David vehemently. But why get into a pi***** contest when we're all pretty much on the same page here. Building bridges, as well as purity, is also how debates are won and consensus built.

Posted by: Don Altobello | Aug 21, 2011 2:59:06 PM

Don, I asked the question to see if we are on the same page. You will note he did not reply.

Posted by: Fr. J | Aug 23, 2011 7:10:37 PM