Medical Ethics Abortion Essays Fetus

Killing another person if that person is a non-aggressor is regarded as a morally terrible action in most moral communities, which have major moral and legal prohibitions and sanctions against such killing. Far fewer moral communities have similar attitudes and prohibitions against killing all living beings and most cultures are willing to kill some living beings for food and for use of their skins and for other benefits such as the advancement of medicine. But what of the human being as it develops from newly fertilised ovum, to pre-embryo, embryo, fetus, new born baby, to unequivocally mature autonomous person with full moral standing including a moral and legal right not to be killed at least if he or she is not an aggressor? When and on what basis during that development does the unequivocally living human being acquire the moral status of a living human person, here used simply as a shorthand for a human being of full moral status (of the sort all readers of this paper uncontroversially ascribe to each other) including a right to life, again here used as a convenient shorthand for the right not to be killed if not an aggressor. Conversely, when, if at all, and why, is it morally justified to kill (“abort”) the developing human being? The answers to these questions are not primarily moral answers, though of course they have major moral implications. Overwhelmingly moral communities do not doubt that to kill a person, at least if he or she is not an aggressor, is, as stated above, a morally terrible action. They agree that people should be protected against such killing by acceptance by all moral agents that every person has a moral and legal right to life. What they disagree about is the scope of that obligation—just what sorts of entities are persons in this sense, and why? Conversely what sorts of attributes manifested by any entity would/should ensure that it is acknowledged to be a person and have full moral standing including a right to life? These are primarily metaphysical and/or theological issues rather than directly moral issues, and people of moral integrity can and do come to carefully thought out but widely different conclusions without in any way undermining that moral integrity, without in any way being “wicked” -or stupid– points that those who are inclined to impugn the morality or intelligence of those who oppose them on this issue should bear in mind and take to heart!

A variety of standard positions have emerged over the centuries. At one end of the spectrum is the fundamentalist stance that claims either that the newly fertilised human ovum is a human person from the moment of conception, or at least that it must be treated as such even if we cannot know precisely when in its subsequent development it becomes “ensouled”—roughly speaking the theological equivalent of becoming a “person” as defined above. The latter position is the position of the contemporary Roman Catholic Church as expressed in its 1974 Declaration on Abortion by the Roman Congregation for the Doctrine of Faith1 and is shared by some other faith communities. A little further on from the “moment of conception” stance is the 14 days stance, developed by the Warnock Commission in the UK when it was considering in vitro fertilisation.2 Here development of the “primitive streak”, at 14 days, was determined to be the cut off point after which research on, followed by destruction of, human embryos was to be prohibited—a cut off point subsequently enshrined in the Human Fertilisation and Embryology Act, 1990. Although the Warnock commission produced little justification for its choice of 14 days, this was subsequently defended in depth by the Roman Catholic philosopher Norman Ford, who argued that the primitive streak stage marked the true formation of a new living individual with a human nature.3 This occurs after a two-week developmental process that follows fertilisation, within what he dubbed the “proembryo” and what Mary Warnock called the “pre-embryo”.

Interestingly St Thomas Aquinas, one of the greatest philosophers of the Roman Catholic faith, proposed (following, as he often did, an Aristotelian lead) that ensoulment or “hominisation” did not occur until 40 days for boys and 90 days for girls.4

A traditional distinction has been that of “quickening”—the time at which the pregnant woman can feel her fetus move inside her (generally around 20–21 weeks in a first pregnancy, often several weeks earlier in subsequent pregnancies)—undoubtedly a time of great emotional significance for the pregnant woman.

Moving along the developmental spectrum, “brain life” (the development of a functioning brain),5 and the development of the ability to have experiences, including sensory experiences (sentience)6 have also been proposed as criteria for differentiating the “fully fledged” human person with full moral status from the developing human being that lacks a right to life. Estimates of the onset of a capacity for sentience vary but 20–24 weeks are commonly proposed.

A technological criterion favoured among many doctors working in neonatology and also in gynaecology is the concept of viability—the stage of fetal development at which the fetus can survive independently of the pregnant woman, given suitable intensive care.7 This seems to be a steadily reducing period but is currently around 20–22 weeks.

The legal criterion in most jurisdictions is birth,8 when the human fetus becomes a legal person, and certainly this corresponds with an enormous psychological change in all involved with the newborn baby—here it is, a new human being joining the human community.

Finally some argue that even at birth a baby is not yet a person, that a necessary attribute for being a person is a capacity to be aware of oneself, and or a capacity to value oneself, or even—in Kantian mode—a capacity for autonomous thinking, and that these capacities develop some time—at least some months—after birth.9 And to round off this thumbnail sketch some argue that a necessary condition for full moral status as a human person is social acceptance as such, and that therefore without such social acceptance a human being of any stage of development does not have the full moral status and rights of a person.

Perhaps the most intellectually robust of these criteria are those at each end of the spectrum, ie the criterion of conception, and the criterion of a capacity for self awareness—but all these criteria have associated problems, and it has always seemed important to me for all of us involved in the abortion issue to be clear what our own positions are and how we respond to the problems and objections associated with our position, whatever it may be. Not much has changed in that respect either since the introduction of the Abortion Act in 1967.

Full moral status from conception or soon afterwards

First the standard Roman Catholic “moment of conception” stance—which for reasons of space I shall here assimilate to the official Roman Catholic stance that while we cannot know when ensoulment or hominisation occurs, we must behave as though it occurred at conception so as to prevent the dreadful sin of killing an innocent ensouled human being or human person. There are two main problems with this position—as with the Ford's unorthodox Roman Catholic view that the human person begins at 14 days: first why should we believe that a single cell or a clump of cells is a person, with the same level of moral importance as we readily acknowledge each other to have? Second are we prepared to accept the implications of this stance for medical practice—for example that we should refuse to permit not just all abortions and all in vitro research on human embryos but also even postcoital contraception, since this works in part by preventing a newly fertilised ovum from implanting into the lining of the uterus?

Now sometimes the first objection is met by the argument from potential. There are two versions of this. The first is what might be dubbed the ordinary language version. According to this version, of course the newly fertilised ovum and early embryo does not have the attributes of a person—it can't think or reflect or imagine or experience, or do things for itself. But it has the potential do all those things, it has in short the potential to become the wonderful being that we fully fledged human beings are. It should therefore be valued and respected for that potential and be accorded the same moral status and protection that we accord each other. The problems with this version of the argument from potential is that we don't normally, let alone necessarily, accord the same value to x which has the potential to be y as we accord to y itself. An acorn has the potential to be an oak tree but not many buyers would pay the same for acorns as they would pay for oak trees. A caterpillar has the potential to become a butterfly but few nature lovers would accord the same value to caterpillars as to the butterflies they might become. Moreover as John Harris has pointed out we all of us have the potential to be corpses—but this in no way justifies treating or valuing each other as though we already were corpses. Moreover, as he also points out, if potential to be fully fledged human people was sufficient to require being valued as if that potential had already been realised then a sperm and an egg considered together also have that potential; and, given techniques of cloning that led to Dolly the sheep, so do many ordinary cells of the human body. Are they all to be accorded a right to life?

The second version of the argument from potential avoids such problems but only by asserting the conclusion it seeks to derive. According to the second version, the newly fertilised ovum is “a human being or person with potential, not a potential human person”.10 According to this version of the argument from potential the newly fertilised ovum and thus the early embryo just is a person from fertilisation; even though its attributes as a person are not yet obvious they are all present in the genetic and organisational structure of the new human being, and left alone to develop, they will gradually emerge. While the subject bears extensive debate and sophisticated analysis, few who are not already committed to a theological requirement that a new human person begins either at fertilisation or else very soon afterwards—for example Ford's 14 days stance3—are persuaded by either version of the argument from potential which is seen either as begging the question by asserting the disputed conclusion as a premise in version two, or as totally implausible special pleading in version one. Many who reject the argument from potential will none the less agree that the potential to become something of great value—for example a human person—undoubtedly belongs to human embryos and fetuses and this gives them at least a prima facie value, and in many cases, where the pregnant woman herself longs to have a new baby, makes them extremely important. But they will be unpersuaded that this potential necessarily imparts the same value—let alone the same intrinsic value—to all human embryos and fetuses.

Aquinas's 40 days for boys and 90 days for girls may be quickly passed over, as may the suggestion that quickening—the feeling of fetal movement by the pregnant woman—is relevant to the moral status of the fetus. In passing it is of note however that Roman Catholic thinking has by no means been univocal, either now or in the past, that ensoulment occurs at fertilisation, and that it is important to differentiate between psychological feelings that are of undoubted importance for the pregnant woman, or indeed for others, and plausible criteria for determining the intrinsic moral status of the embryo and fetus.

Brain life and the capacity for sentience

What about the fetus's development of a brain, and along with that its development of a capacity for sentience—a capacity to have experiences including sensory experiences, whether of touch or pain or of sound? Are these plausible criteria for the “personhood” or moral inviolability of the human fetus? There seems little doubt that it is because of our brains that we humans have special attributes to which we attach special moral value—of which the most important one is widely accepted to be our capacity to be autonomous—to think reflectively for ourselves, or what amounts to much the same thing, to have “free will”. Moreover at the end of our lives it is now widely accepted that it is the death of our brains that is the fundamental determinant of our deaths and of the cessation at any rate of our legal personhood. Should therefore the corresponding onset of “brain life” be the determinant of the start of our moral and/or our legal personhood? And should the capacity for having experiences and especially sensory experiences constitute the operational evidence of the onset of such “brain life”? Some anti-abortion activists have made much of evidence that at a late stage of pregnancy fetuses respond to stimuli in ways that indicate that they are sentient, and for my own part this seems quite likely—after all there's not much doubt (these days) that a newborn baby is sentient—capable of feeling pain and of other experiences; it seems highly implausible that this capacity is in some way switched on by the process of birth and far more likely that it is already present at some stage in utero. The question still remains, is sentience of the human fetus a plausible criterion for personhood—for fetal “moral inviolability”, including a fetal right to life?

A major problem for such an assumption is that if the capacity of sentience is sufficient for personhood and a right to life in human fetuses why should it not equally be sufficient for personhood and a right to life in all other living beings, including all the vertebrates that we currently are ready to kill for their meat and skins and uses in medical research? Of course many animal rights supporters would not see this as a problem at all—but merely as confirmation that our current moral and legal attitudes to animals are grievously mistaken and “speciesist”. They would agree with Jeremy Bentham, one of the founding fathers of utilitarianism, that all animals who can experience pain and suffering, pleasure and happiness are of equal moral concern and that the proper expression of that moral concern is to minimise suffering and pain and maximise pleasure and happiness, whether animal or human. Without some additional premises making a special case for humans, those who would make the capacity for sentience a sufficient criterion for fetal personhood seem logically committed to a similar position, as are those who would accept as such a criterion the existence of a fetal brain with the capacity for sentience. One practical moral conclusion is important to note. If sentience is not accepted as the criterion for full moral status, and abortion continues to be permitted after the stage at which the fetus has developed the capacity to feel pain, then it seems morally important to ensure that the fetus is not caused pain by the procedure itself—so for late abortions some form of anaesthetic or other means of preventing fetal pain should be part of the abortion operation.

Viability is the criterion favoured by many who work in the field of neonatology, and also by some gynaecologists who accept abortion but who also believe that at some stage in their development fetuses acquire a right to life after which they should not be aborted. There is a crucial practical as well as intuitive dividing line, such doctors often feel, between those fetuses who, given intensive care are capable of continuing their survival and development outside the uterus, and those who are not viable in this sense and it is this viability, they believe, that affords a criterion for distinguishing between those fetuses that do and do not have a right to life.

The main problem with the viability criterion is that it is entirely dependent on our technological skills. If what we are looking for is some characteristic(s) of the developing human being itself, in which to ground its intrinsic moral status, then the skills and technologies of others are hardly likely to suffice; yet viability is a criterion that depends almost entirely on the technological skills of others. Even these days there will be an enormous difference between fetal viability in a Third World village and in a First World neonatal intensive care unit. Moreover given the exponential development of human technological inventiveness—wizardry some might call it—Aldous Huxley's Brave New World possibilities of growing human embryos and fetuses entirely outside the human body could become reality–in which case the criterion of viability will have collapsed into the criterion of fertilisation.

So does the legal criterion—birth—get us out of our difficulties? Legally speaking the answer is largely yes—for UK law, like that of many other jurisdictions, is explicit that a fetus is not legally speaking a person and does not have the legal rights of persons including the right to life enjoyed by (natural) persons, whereas a born child is a person and does have a right to life. While in practical terms the simple criterion of birth is generally easy to apply and corresponds to a stage when what was previously hidden and private inside another human being is now a revealed, public, and clearly separate social entity, as a criterion for moral differentiation of a human being's intrinsic moral status it seems highly implausible. Essentially it is a criterion of what might be dubbed biological geography, asserting that a human being does not have a right to life if it lies north of a vaginal introitus but has a right to life once it has passed south and has (entirely) emerged from the vagina. What morally relevant changes can there have been in the fetus in its passage from inside to outside its mother's body to underpin such a momentous change in its intrinsic moral status?

Self awareness

Finally, criteria that require not just a capacity for awarenesss, experience or sentience as a necessary condition for being a person with full moral status, but that require a capacity for self awareness as a criterion for personhood. Such approaches are usually grounded in the notion that what is remarkable and of special moral importance about human beings is their ability to reflect rationally, to be aware of their moral natures and their responsibilities to others and to themselves, and to be able to make autonomous decisions based on such reflection, to be agents who have free will. Following the lead of the 17th century physician-philosopher John Locke, a capacity for self awareness is regarded as at least a necessary condition by those, including myself, who accept this approach to the attributes needed to be a person On this basis a newborn child is not a person, for neonates do not have such capacities; and therefore on this basis newborn babies would not have any intrinsic right to life stemming from their natures. This fact alone is so counterintuitive—even horrifying to some–that for many it affords a reductio ad absurdum—any argument that leads to a conclusion that newborn babies are not people and do not have a right to life must be flawed and should in any case be rejected for leading to such absurd conclusions. While such a summary way with arguments that lead to conclusions that seem absurd or at least highly counterintuitive may feel satisfying, it does not dispose of the arguments. Nor does it dispose of a widespread intuition that in the case of very severely handicapped newborn babies parents and doctors who agree that it would be better if the infant did not survive and live a life of severe handicap should be permitted, morally and legally, to allow them to die, even in cases where medical and nursing intervention could be expected to save them, and even in cases where they would not permit similar latitude of choice on behalf of an older handicapped child or adult.

Abortion for abnormality an affront to disabled people?

It should be clear therefore that any substantive position on when a new human being should be considered to be a human person–a human being with full moral standing including a right to life and thus a right not to be killed at least if not an aggressor–has associated problems. This has not changed since these issues were debated in the 1960s. What has changed, however, is the debate about abortion on grounds of fetal abnormality, one of the least controversial clauses at the time David Steel's Abortion Bill was being debated. These days an increasingly forceful disability rights movement is arguing that abortion on the grounds of fetal abnormality is morally and legally objectionable in discriminating against disabled people and in manifesting and encouraging disrespect, hostility and contempt for disabled people. In this last section of the paper I shall give the gist of my rebuttal of this argument. First, of course, it is important to be clear that the argument is logically watertight if it is agreed that human fetuses (and embryos) are people, and thus that fetuses and embryos with disabling abnormalities are disabled people. If that is the starting position then of course the argument is impeccable, and to abort–that is, to kill–fetuses on the grounds that they have abnormalities that are disabling is as morally repugnant as it would be to kill adults who have disabling abnormalities. It would indeed manifest and encourage disrespect, hostility, and contempt for disabled people.

But are those of us who justify abortion for sufficient benefit and who therefore must reject the claim that fetuses are people or persons with full moral status including a right to life, to be found guilty of such discimination if we justify abortion on the grounds of fetal abnormality? The answer is unequivocally no!

Instead what we seek to justify is availability of choice to pregnant women to prevent the creation of disabled people by aborting fetuses with abnormalities that would disable the people they would become—if they were allowed to develop into people. If the response to this argument is that such fetuses already have a right to life, disabled or not, then the response is, as noted above, logically impeccable but begs the question about the moral status of the fetus by asserting that it has full moral standing. If that assertion were accepted then, as noted above, it is as morally wrong to kill a disabled fetus as to kill a disabled child or adult, and as wrong to abort a normal fetus as it would be to kill a normal child or adult.

If, however, the fetus is held not to have full moral status and not to have a right to life, then aborting an abnormal fetus shows no more disrespect or hostility to disabled people than aborting a normal fetus shows disrespect or hostility to people who don't have disabilities. It shows no more disrespect to people than deciding not to become pregnant at all shows disrespect to people. To permit people to have abortions in order to allow them to choose not to bring a disabled person into being in no way justifies, let alone does it entail, any undermining of our obligations to look after and care for, respect and be fair to the disabled people who do exist. If embryos and fetuses are not yet people or persons—if they do not yet have full moral status including a right to life, then there is simply no logical connection between making abortion available to prevent the creation of a disabled person and discriminating adversely against disabled people.

References and notes

In an influential essay entitled Why abortion is wrong, Donald Marquis presents an argument which purports to derive the immorality of abortion from a deceptively simple but intuitively compelling claim: it is presumptively wrong to kill us, competent adult human beings, because doing so destroys our most valuable possession, a future of value.1 Marquis claims that killing actual persons is wrong because it unjustly deprives the victim of his or her future; that the fetus has a future similar in morally relevant respects to the future lost by a competent adult homicide victim,and that, as consequence, abortion is justifiable only in the same special and extreme circumstances in which killing competent adult human beings is justifiable. Marquis presents the gist of the Future Like Ours (FLO) argument in this way:

“. . .we can start from the following unproblematic assumption: it is wrong to kill us. . . when I am killed I am deprived of all of the value of my future. Inflicting this loss on me is ultimately what makes killing me wrong. The future of a standard fetus includes a set of experiences, projects, activities and such which are identical with the futures of adult human beings and the futures of young children. Since the reason that is sufficient to explain why it is wrong to kill human beings after the time of birth is a reason that also applies to fetuses, it follows that abortion is prima facie seriously wrong.”2

The Future Like Ours argument has been criticised on the grounds that it ignores the point of view of the pregnant woman; that it is incompatible with contraception and abstinence; and that it understates the explanatory resources of the competing personhood theory while overstating its own explanatory power.3 These objections make a powerful cumulative case that something is amiss in FLO, but none come to grips with the metaphysical thesis at the heart of the argument: the claim that actual persons possess a future of value. What exactly does it mean to have a future of value?

The expression is ambiguous. It could mean that actual persons have a potential future of value in the sense that given favourable conditions they are likely to have a worthwhile life; or it could mean that actual persons have a self-represented future of value in the sense that they can construct mental representations of valuable futures. The FLO argument turns upon this ambiguity. The expression occurs twice in the argument, first in the claim that homicide is presumptively wrong because it deprives its victim of a future of value, and second in the claim that both actual persons and fetuses have a future of value. The Future Like Ours argument would be valid if “future of value” were used consistently to mean either “potential future of value” or “self-represented future of value”, and FLO would be sound if one or the other interpretation supported both the moral claim and the metaphysical claim, but if any interpretation which makes the argument valid renders it unsound, then FLO must be rejected. I first argue that the potential future of value interpretation is unsound because it is not presumptively seriously wrong to deprive someone of a potential future of value. I then argue that the self-represented future of value interpretation is unsound because the fetus does not represent its future. The essay concludes with an analysis of the intuitive appeal of the Future Like Ours argument.

I

The Future Like Ours argument might be salvaged if homicide were presumptively wrong because it deprives a human being of a potential future of value, whether or not that human being ever imagined his or her future. In this case, the expression “a future of value” could be used consistently throughout the argument: killing persons is presumptively wrong because it deprives them of their potential future of value; a fetus has a potential future of value; thus killing a fetus is presumptively wrong. The second premise is plausible. In most cases the course of a pregnancy can be foreseen with enough confidence to predict that the fetus will be born as an infant who has the capacity to enjoy a life qualitatively similar to the lives of actual persons.

The first premise is implausible, in part because a potential future of value interpretation implies welfare rights which most people would reject in other spheres of life. If deprivation of potential futures of value is presumptively a form of culpable homicide, then culpable homicide is committed whenever a person is denied access to what he or she needs to live. A homeless man who dies of exposure, an elderly woman whose unheated apartment precipitates a fatal case of pneumonia, an injured child who dies for want of a suitable blood transfusion would all be homicide victims. Each case is tragic in its own way, but it is far from clear that these persons' rights have been violated. Persons can die in ways which do not violate their rights.4 This is not to say that no harm is done when a potential future of value is foreclosed. On the contrary, to prevent a person from acting upon a highly reliable anticipated future imposes upon them significant opportunity costs, but it does not necessarily treat him or her unjustly. Only if the person had a right to the favourable circumstances which make possible a potential future of value would depriving him or her of that future be presumptively wrong.

For example, the future quality of life of many actual persons depends critically upon whether they receive prompt and effective medical treatment. Many persons with end stage renal disease could expect bright futures if they were to receive a kidney transplant, but neither medical need nor therapeutic benefit entitles these persons to medical services. Patients have a right to life-enhancing medical interventions because they subscribe to a health care plan which covers the procedure or because they are citizens of a country which maintains a functioning system of universal health care or for some other reason, but they do not have a right to medical services, or to any other external good, simply because they would have a better future if someone were to provide for their needs.

The potential future of value of the fetus is no less dependent upon favourable external circumstances. Since the fetus will become a person who has the capacity to enjoy its life and derive meaning from it only if it has access to the reproductive system of a woman, abortion would be presumptively wrong only if women had no presumptive right to control access to their reproductive systems. The fetus certainly needs its uterine environment if it is to realise its potential, but persons do not in general have a right to satisfy their needs at the expense of the autonomy, bodily integrity and wellbeing of another person. If I need a bone marrow transplant in order to realise my potential future of value, I do not thereby gain a right to your bone marrow, even if you are my mother. Perhaps pregnancy creates more stringent duties than motherhood, but if so, an argument is needed to establish this claim, an argument notably absent from Marquis's presentation of the Future Like Ours argument.

A defender of FLO might object at this point that abortion kills the fetus and that killing a person does violate his or her rights in all but the most extreme circumstances, even if depriving him or her of life-sustaining services need not, but this is not a distinction that can be drawn within a potential future of value interpretation of FLO. Someone who has been killed and someone who has been denied access to life support have been deprived equally of their potential futures. The potential future of value interpretation fails because the moral premise if true implausibly entitles persons to welfare rights to valuable futures in addition to liberty rights not be killed. A self-represented future of value interpretation is needed to distinguish between the right not be killed and the right to valuable futures.

II

The Future Like Ours argument would be valid if the expression “a future of value” consistently meant “a self-represented future of value”. Substituting in, the argument would look like this: killing persons is presumptively wrong because it deprives them of their self-represented future; fetuses have self-represented futures; thus, killing fetuses is presumptively wrong. The first premise is plausible. At any moment a person can project a representation of a self which extends over time, a self understood from the perspective of the present, reconstructed from present remnants of the past and projected from the present into many possible futures. Persons care about their self-represented futures and their memories, their self-represented past, because this self-conception defines who they are and confers meaning and significance upon what they think and do. In contrast with potential futures, self-represented futures do not depend upon outside agencies for their realisation. The value of a self-represented future resides within the person herself, as a feature of a richly complex mental life. Killing a person deprives her of this future: her hopes and dreams are dashed, her goals unfulfilled, her sins unforgiven, longed for reunions and reconciliations never occur. All of this happens in the present, to a person able to unite in a moment of self-consciousness a personal past, present and future. One reason why killing persons violates their rights, but depriving them of life support need not, is that killing persons deprives them of a future and a past which is rightfully their own because it is something they themselves have created.

Even if killing a person is presumptively wrong because it deprives its victim of his self-represented future, this cannot be a reason why it is wrong to kill a fetus because the fetus does not construct mental representations of its future. The neurological and embryological evidence of this issue is clear.5 Higher order cognitive functioning of the type implicated in planning and memory is dependent upon massive cortical/sub-cortical connectivity. Sub-cortical thalamic fibres first begin to form synapses with cortical neurons at about twenty-five weeks' gestation and only at some point well after birth does connectivity reach a critical threshold sufficient for self-awareness. A third trimester fetus may be sentient but there is no medical reason to think it is capable of self-consciousness.

The Future Like Ours argument rests upon two substantive claims: (1) killing persons is presumptively wrong because it deprives them of a future of value; and, (2) fetuses have futures of value. The plausibility of the first claim depends upon the intuition that persons suffer significant harm when prevented from experiencing their self-represented future, but since the fetus does not represent its future it cannot be harmed in this way. The plausibility of the second claim depends upon the proposition that both the fetus and actual persons have a potential future of value, but unless one has a right to the conditions under which this potential can be realised, neither homicide nor abortion are presumptively wrong for this reason. The self-represented future of value interpretation underwrites the moral claim about the wrongness of homicide but militates against the metaphysical claim that persons and fetuses are relevantly similar; the potential future of value interpretation uncovers a genuine commonality between persons and fetuses but not one which can support the moral claim that abortion is presumptively seriously wrong. We may conclude that the Future Like Ours argument retains its force only if one equivocates on the concept of a future of value.

III

How, then, can the enormous intuitive appeal of the Future Like Ours argument be explained? The answer, I think, lies in the subtle and pervasive influence self-representation exerts upon our experience of time. The intentions, memories, hopes, dreams and plans which define us as persons elicit in us powerful intuitions of temporal extension, for ourselves and on behalf of others. Just as the past can come alive in memory, a long-awaited future can feel more real than the present. Everyone has had the experience of seeing a longed for future evaporate as events unfold in unexpected and unwelcome ways. When this happens, the sense of loss is palpable, even though nothing physical has been taken away. Nowhere is the reality of a self-represented future more evident than in the attitudes of the dying and bereaved. AIDS victims understand how a foreseen death can alter the experience of time; grieving parents dwell upon how empty their own experience of the passage of time has become. In each case, the past and the future become humanly accessible through mental representations, all of which are expressions of the current mental state of a self-conscious person.

The Futures Like Ours argument is beguiling because in ordinary circumstances potential futures of value are linked to represented futures of value. Indeed, this linkage is the point of contingency planning. As agents, persons act upon the value they assign to representations of their own future precisely because they believe that given favourable circumstances their imagined scenarios will correspond to valuable states of affairs. This linkage between represented futures and potential futures is deeply ingrained in practical reasoning. Any form of delayed gratification or other sacrifice of current interests presupposes a representation of a future valued more highly than the present. Savings schedules, life insurance and long term investments make sense only against the backdrop of a perceived future of value; frustrated and impoverished graduate students must remind themselves of the rewards of perseverance; and perhaps most starkly, cancer patients undergo burdensome therapies in the hope that doing so will prolong their futures. Other cancer patients refuse medical intervention in order to have a future perceived as more valuable because free from the toxic effects of chemotherapy. In these and countless other cases, patients consent or withhold consent to medical treatment based upon a judgment of the relative value of alternative futures. All of this is an intelligible and perfectly reasonable response to represented futures believed to be potential futures.

Parenting

Represented futures and potential futures are conjoined no less when one imagines the future of someone else. When a person enters into relationships she may empathise with and act on behalf of others in the expectation that some of her mental representations of their future will be realised. Parenting is a sphere of life dominated by thoughts of the future on behalf of others. Parents routinely, sometimes obsessively, contemplate the future of their children, hoping that some scenarios will come true and fearing the realisation of others. Why else subject our children to the discipline of learning to read and playing the violin or to the pains of orthodontia? Why else lose sleep over the perils of bicycles, motorcycles and rollerblades? Parents become obsessive about safety because they believe that nothing would be more difficult to bear than the death of their child. The natural, almost inevitable, thought of grieving parents is that the future of their child has been snatched away, that their child has lost a future of falling in love, of worldly success, of raising children of her own and a thousand other worthwhile experiences.

For many women, the thought of the lost future of a fetus aborted in their youth haunts them for a lifetime. These women may replay in their minds first words not spoken and birthdays never celebrated with the same vivacity with which they regret missed opportunities in their own lives and in the lives of their children. These women grieve for their lost child because they have solidly paired a mental representation of a future life as child for their aborted fetus with the potential future of the fetus as it was at the time of the abortion. These attitudes are understandable, but should not impose limits upon the reproductive freedom of other women. One can sympathise with the grief-stricken without accepting their beliefs as philosophically perspicuous constraints upon the resolution of problems in medical ethics. Dying people, for example, may exercise their liberty interest in controlling the terms of their own death by creating the illusion of normalcy; Jehovah's Witnesses may give expression to their religious convictions by refusing blood transfusions, but in neither case do the beliefs of these persons need to be taken as true to be taken seriously.

Similarly, one can understand the natural propensity to attribute retrospectively to the fetus the status of a person because in many spheres of life, including parenting, it is entirely reasonable to think and act as if a predictable outcome were actual. In other spheres of life, the connection between represented futures and potential futures is best severed. When drawn into a fictional story for example, or engaged in fanciful daydreams or when under the sway of irrational fears, the proper response is to recognise that one's thoughts fail to correspond to reality. If the fetus is not self-conscious, as the embryological evidence indicates, feelings of regret (and moral outrage) on its behalf are unfounded in the same way feelings of regret and moral outrage on behalf of a fictional character are unfounded. In neither case, is there an appropriate extramental subject of experience upon which to direct our attitudes. One may imagine a future for a fetus in which he or she had his or her own (unfulfilled) hopes and dreams, but one should not fall into the trap of thinking that the fetus as it was at the time of an abortion had a self-represented future to lose. One may mourn the absence of the child the fetus would have become, but in doing so one is coming to terms with a painful mental representation in one's own mental life, not acting on behalf of a person who had a future of his or her own.

Aborted fetuses

What, then, of the millions of aborted fetuses? Have they been deprived of their future? We may represent a future for them if we choose, but, it is we, self-conscious persons, who make this future. We can also project ourselves into a past of which we have no memory, into early childhood, infancy and in utero. We can represent our self as the human being who is continuous with the infant in the baby pictures and with the fetus in the ultrasound. If we represent the past in this way, we will alter our experience of time and in so doing elicit powerful intuitions of temporal extension and empathetic identification. We can, if we wish, represent to ourselves a future for a fetus, but this is not something the fetus can do. A self-represented future is a terrible thing to lose but this is not a misfortune which can befall a fetus. And a potential future is not a benefit to which the fetus has a right. Either way, FLO fails.

References and notes

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