ISSN: 2376-127X
Journal of Pregnancy and Child Health
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Case Report 黑料网
Abort or Let Be Born
| Shahnaz Shahid* | |
| Midwifery Programme Coordinator & Senior Instructor, Aga Khan University School of Nursing and Midwifery, Pakistan | |
| Corresponding Author : | Shahnaz Shahid Midwifery Programme Coordinator & Senior Instructor Aga Khan University School of nursing and Midwifery Pakistan Tel: 021349335470 E-mail: shahnaz.shahid@aku.edu |
| Received February 16, 2015; Accepted June 29, 2015; Published July 04, 2015 | |
| Citation: Shahid S (2015) Abort or Let Be Born. J Preg Child Health 2: 175. doi: 10.4172/2376-127X.1000175 | |
| Copyright: © 2015 Shahid S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
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| Keywords |
| Abortion/abort; Ethics/ ethical principles; Birth; Adoption; Cameron’s ethical decision model |
| Introduction |
| Abortion is a common issue in many parts of the world. Pakistan has an estimated rate of 29 per 1000 women having abortions annually [1]. Reproductive health of individuals is important in case of abortion; hence health professionals including midwives can play an important role to improve the health of the population [2]. When a woman undergoes abortion, she has a feeling of guilt and at times she thinks she is an incomplete woman. In this regard, midwives can help the woman to express her feelings and provide her psychological support to cope with the problem. Couple counseling is also important in case of abortion, because in many cultures husbands are the decision makers to decide for seeking health care. Furthermore, midwives can discuss about the reproductive rights of women and ensure provision of respectful care. Evidence from East Asia suggests that parents use prenatal sex testing to selectively abort female fetuses, is a practice manifested in rising sex ratios (males per females) at birth [3]. |
| Case Scenario |
| Mrs. X, a 25 years old pregnant woman with gestation of 24 weeks, second gravid, para 1+0. The expectation of her family was to give birth to a boy as the first child but he delivered a girl. She says that if this time she again delivers a girl so her husband will ask her for separation. Her ultrasound shows she is having a baby girl again, but her husband is not aware of it. Mrs. X says that if she tells her husband that this time again there is a baby girl, her husband will ask her for abortion, but she doesn’t want to abort her unborn baby. |
| Analysis |
| Mrs. X delivers the baby and let someone to adopt the baby. If she goes for induced abortion then she will be taking the life of her unborn daughter. Thus, for social reasons abortion is not permitted [4]. As the fetus possesses humanity so her life should be preserved. Selfdetermination implies to have freedom to make choices about issues affecting one’s life. As the unborn fetus has right to life; and if the fetus is not aborted so fetal rights will override the mother’s right to control her body and right to choose. |
| Autonomy is derived from Greek word autos meaning “self ” and nomos meaning “rule or governance” [5]. Kant (2001) states that respect for autonomy recognizes all persons have unconditional worth; everyone has the capacity to determine their moral destiny [6]. In case of Mrs. X, autonomy is violated because of the fetus right to life. Prolife thinkers believe that abortion should not be done and the ultimate solution is to have the child and basically live with it. |
| Many conservative Muslim theologians express disapproval of abortion, but there is sufficient room in Islamic tradition for performing it. Where Muslim teachings do allow for abortion, it is generally limited to the early stages of pregnancy that is before 120 days and only on the condition that there are good reasons for it. Even later, abortions may be permitted, but only if it can be described as the lesser evil and if not having an abortion would lead to a worse condition of the mother. Moreover, abortion is prohibited because of the personhood of the fetus. |
| Islam views adoption as a distortion of the natural order of the society. Taking a stranger into the family as one of its members and allowing him to be with woman who are na-mehram (i.e. non marriageable relatives) to him is a dishonesty, for the adopter’s wife is not the adopted son’s or daughter’s real mother, nor is his daughter the boy’s or girl’s sister, nor is his sister the boy’s or girl’s aunt. The central notion of justice in the Sharee’ah is based on mutual respect of one human being for another. The just society in Islam means the society that secures and maintains respect for people and their rights through various social arrangements that are in the common interest and welfare of the general public. In case of Mrs. X, adoption will be the way to save the innocent baby. |
| On the other hand, if Mrs. X decides to abort the baby, then mother’s life as well as fetus life is involved. If Mrs. X goes for abortion so rights of woman to choose will override the rights of the fetus life. In regard to autonomy, woman should not be forced to deliver a baby. Hence, to respect an autonomous agent is, to acknowledge that person’s right to hold views to make choices, and take actions based on personal values and beliefs; thus Mrs. X can abort the baby if she wishes so. According to the pro-choice followers, abortion can be the solution because of reasons they feel are appropriate. In Mrs. X case, husband is being the decision maker as in most parts of Pakistan, the status of women is low and they are responsible to act upon their spouse orders. Although, Islam preaches equal rights for men and women, but many Muslim scholars insist that men are more powerful and more respectable than women so they should be husband’s followers. Anecdotal observations in Pakistani culture show that since birth, girls are treated very differently and the elder females in the families are the ones who make the girl realize that she is a girl who is born to be a follower to her father, brother, husband and son. Hence, as the girl grows, her feeling of inferiority becomes strong. Likewise, Mrs. X husband believes that he has control over his wife’s body so he is determining ethical principle of paternalism. Therefore, he is taking decision on his wife’s behalf for not having a baby girl. |
| Application of Cameron’s ethical decision model (2000) [7] |
| Cameron’s model consists of three steps talking about virtue ethics focusing on individual values and beliefs. This model is applied here, because the author feels that application of Cameron’s model in this case has helped to take a position by exploring and discussing the ethical principles in the light of virtue-based theory. According to the virtue-based theory, a virtuous person is likely to be generous, caring, compassionate, and fair by character. Pertaining to Mrs. X, it seems that she is concerned for her baby and she wants to do just with her baby by giving her birth. The following three steps of the model are applied below to discuss and analyze the case. |
| What should Mrs. X believe? |
| Mrs. X believes that life is sacred; hence she should preserve the life of the innocent baby. Islam doesn’t allow taking anyone’s life, so being a mother how baby’s life can be taken. She is certain that it is not the fault of the fetus to be a girl. As a result, Mrs. X feels to deliver the baby and save her life, because she has the right to continue her pregnancy and disagree with her husband’s decision regarding abortion. |
| Who should Mrs. X be? |
| Mrs. X wants to be a caring person, viewing her fetus as a human being rather than an object. Thus, she respects her fetus’s dignity by valuing her to be a person. She is convinced to continue her pregnancy till term and disobey her husband. |
| What should Mrs. X do? |
| Mrs. X wants to discuss with her husband to allow her to deliver the baby as it is not the mistake of the baby to be a girl; in fact it is God’s wish. She strongly feels of delivering the baby and giving her to someone for adoption; as in this situation the lives of all three individuals are not ruined. |
| Final position |
| I would opt for the position, which talks about delivering the baby and letting someone to adopt the child. The reason for selecting this position is that as human beings we do not have right to take anyone’s life; and abortion is not a moral choice. According to the utilitarianism theory an action can be morally right if the consequences of that action are more favorable. We should do whatever that benefits the humanity. The Islamic term for adoption is “kafala”, which comes from a word that means “to feed”. The prohibition of legal adoption in Islam was ordained to protect the rights of the adopted, adopter, biological parents, and other individuals including the society as a whole affected by the adoption [8]. |
| According to the Holy book of Muslims, one cannot become a person’s real son or daughter merely by virtue of a declaration; God says he has not your claimed (adopted) sons your true sons. Allah guides that call the adopted children by their names and by the names of their father; and one who does this is more just in the sight of God (Holy Book 33:4-5). Pro-life, who are against abortion think those women who had abortions, fear being rejected by God and loved ones? Hence, it is a traumatic experience to abort the fetus. Thus, it is morally wrong to end the life of the unborn baby. Much of the debate in regard to abortion focuses that, whether the fetus is a person or no. Islam supports the phenomenon that the foundation of fetus is the fusion of the male and female living cells. As the fetus is a person, then she/ he have the rights that belong to persons, including the right to life. |
| Abortion after 120 days is a crime; except only when the continuation of pregnancy can result to threat mother’s life, then only according to Sharee’ah and law abortion can be performed. Abortions that are carried out before the unborn child’s organs have been formed are prohibited except when it is performed in good faith for the purpose of saving the life of the woman or providing necessary treatment [4]. On the killing of human life the Holy Quran states: “Do not destroy a life that Allah has declared sacred except for just cause” (25:69). Consequently, for the sake of our social, moral and spiritual well-being we must adopt a philosophy of life and man that acknowledges God given rights and corresponding duties, affirms the intrinsic moral worth and dignity of human beings including handicapped, elderly and unborn human beings and upholds the sacredness of sex, marriage, family and human life [9]. |
| Helmut Thielicke [10] in his work “ Being human, becoming human”, points out that from the utilitarian perspective, humanity is not given the dignity of being an end itself in Kant’s sense but is a means to end of production. There is no infinite worth of the human soul, no privilege that differentiates humanity from things, no according of qualitative distinction9. Literature supports that abortion is the massacre of an innocent person at the very beginning of life. But pro-choice activists support abortion by saying that the unborn is not a person [11]. However, modern science has clearly confirmed that human life begins at the moment of fertilization [12]. Therefore, the basic concept highlighting that a human embryo has life leads to prohibition of abortion [12]. |
| Abortion is more dangerous than childbirth. Mrs. X physical and psychological health will be affected when she will go for abortion, because when a woman is exposed for the removal of the retained products of conception she will be prone to minor infections such as bleeding, fevers, chronic abdominal pain, gastro-intestinal disturbances, vomiting. Woman can suffer from major complications for example excessive bleeding, embolism, perforation of the uterus, post anesthesia complications, etc. Hence, when she has abortion, her well-being will be disturbed as she will face illness. |
| Consequences |
| Right to self-determination of the woman is violated if the fetus is not aborted; thus the woman has the right to decide about her fetus. It is morally repellent to force a woman to bear a child against her will; but in Mrs. X case, she is being forced by her husband to abort the baby. As the woman has individual health rights so it is not required of her to get husband’s approval to continue a pregnancy. So if Mrs. X delivers the baby then the fetus right to life is given importance and woman’s autonomy is respected. |
| Implementation |
| Abortion is one of the most difficult and controversial moral issues that should be considered, so we should appreciate the value and sanctity of life. Importance of health education must be emphasized because Pakistan has one of the lowest records in female health and education; and one in 38 Pakistani women dies due to pregnancy related causes. Women rights should be considered by favoring pro-choice referring to the view that a woman should be able to retain individual control over the decisions relating to abortion and fertility. |
| Conclusion |
| As professionals we should work to alleviate the helplessness of women; and involve men in decisions related to women’s reproductive health. The abortion law4 defines the stages of pregnancy in terms of the formation of organs or limbs. The law is somewhat ambiguous, as there is no clear demarcation of the two stages of pregnancy or definition of what constitutes “necessary treatment”. It is critical to review the law so that such ethical issues can be solved efficiently keeping in mind the ethical principles. |
References
- Sathar ZA, Singh S, Fikree FF (2007)
- Argent V, Pavey L (2007)
- Goodkind D (1996)On substituting sex preference strategies in East-Asia: Does prenatal sex selections reduce postnatal discrimination? Population and Development Review, 22(1), pp. 111-125
- Pakistan Abortion Law (1997)
- Beauchamp T & Childress J (2001)Principles of biomedical ethics (5th ed.). New York:Oxford University Press.
- Hopkins R (2001) Kant, Quasi-Realism, and the Autonomy of Aesthetic Judgment.European Journal of Philosophy, 9(2): 166-189. DOI: 10.1111/1468-0378.00134
- Cameron ME (2000)
- Huda (2008)
- Mustafa. Z. (2009). Untold story of abortion. Medical News Today.
- Thielicke H (1984)
- Paul J(2006)
- O’Rourke KD (2012)Is the human embryo a person?
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