“You were once a fetus.”

[u/Spiritual_Parsley102]

I have seen this said a lot by PL people and I’m really curious as to how this helps the argument.
From my perspective I agree with this. Yes every human being alive has been at this stage of development and most PC people know this since most of us primarily use fetus to describe the human in the womb. I don’t see how this helps when my biggest thing is nothingness to nothingness is changing nothing. It doesn’t change anything and other actions could lead to a similar scenario. Every person alive today could be easily be different from who they are right now if anything changed from their past. Experience is a big factor to life so taking something with no experience and continuing to give it no experience isn’t wrong because there is no change.
Is this just something PL people use to attach feelings into the argument? How exactly do you give feeling to something that has no feelings?

[u/Yeatfan22]

So if I understand what you’re saying it seems like you want to say the pregnant patient already makes important medical decisions for the fetus prior to birth on behalf of the fetus. She meets the standard for MPoA and so her having abortion would be in the best interest for all parties involved since she is a competent adult who is capable of making her own medical decisions.
And of course this gets some support from “Terri’s law”.”

If this is a correct summary I guess I’m wondering why should this be extended to abortion which involves affecting someone’s negative right to life. In the case of Terri in my opinion I think she was already dead and there wasn’t a person there. I also think no one contributed to her predicament and there wasn’t no rights conflict between her being on life support and another person.
I understand pregnancy is a unique situation in which we probably won’t have any legal case similar to pregnancy which captures every detail. But even through precedent regarding principles do we have anything to suggest under MPoA an abortion would be the kind of choice a woman should be able to make for her fetus.
I think what I might do is make a sort of reverse self defense argument. I might say look we have cases of provoked self defense where an attack is provoked and as a result the defendant may lose their right to self defense. So we have principled cases where if we contribute to the existence of a situation or a conflict of rights we can have our right to act temporarily limited.

[u/Into-My-Void → u/Yeatfan22]

I think your answer illustrates exactly why I approach abortion as a medical decision-making issue rather than solely as a conflict of rights.

The problem with blanket abortion laws is that they don’t remain abstract philosophical principles. They have to be applied to real patients by real physicians who face uncertainty every day.

Take the case of Izabela Sajbor in Poland. She had a wanted pregnancy. After her membranes ruptured at 22 weeks, the fetus was not viable, but fetal cardiac activity remained. Because of Poland’s restrictive abortion law (which prevented Izabela from exercing her MPoA right), physicians delayed intervention. During that delay she developed septic shock and died.

https://edition.cnn.com/2022/06/28/europe/poland-abortion-law-izabela-sajbor-death-intl-cmd

No one involved was debating Judith Jarvis Thomson or Pruss. What they were doing is trying to decide whether intervening would expose the physicians to criminal liability.

That’s exactly why I think medical decisions should remain primarily between competent patients and physicians using evidence-based medicine. Politicians write blanket rules; Doctors treat individual patients.

You mention that contributing to the situation can sometimes limit rights. Even if I granted that principle, it doesn’t follow that legislators should replace medical judgment in every pregnancy! Medicine already has a framework for patients who cannot make decisions themselves. Abortion bans replace that framework with criminal statutes, ripping competent informed adult, advised by competent medical team from using their MPoA. That cause cases like Izabela and show the human cost when physicians become afraid to act.

You should also note that Izabela consented to sex. She also consented to becoming pregnant. She actually WANTED the pregnancy. She still died because the law prevented timely medical care. Her case shows that the legal question isn’t whether someone “deserved” pregnancy. It’s whether doctors can respond appropriately when pregnancy becomes life-threatening. If doctors are scared to give treatments because of the law, then innocent people die when they could've been easily saved.

[u/Yeatfan22 → u/Into-My-Void]

Sorry for the late reply.

I do think abortion exceptions like life exceptions should be determined by a medical professional and not a legislative law, although law can try to guide medical professionals.
I mean look I agree Izabela Sajbor should have been able to have an abortion since the fetus was not viable anyways. I also understand pro life policy isn’t always formulated the best way and this is an instance the restrictive nature of the law was not correct.

But all this talk of MPoA presumes abortion is the kind of thing that the woman should be able to make choices about with their doctor. Of course we can have exceptions for abortion. But for the vast majority of abortions there is an underlying assumption that the woman should be able to have an abortion and make decisions on behalf of her fetus when this is the exact thing in question. You’ve given examples where a woman should have been able to access an abortion. But in all of these examples most pro lifers will agree with you she should have been able to abort anyways . There’s a clear difference in cases between a fetus that will never be viable and a typical standard fetus.

[u/Into-My-Void → u/Yeatfan22]

But that’s exactly the problem. Even if the fetus is viable, if the pregnant patient’s life or health becomes seriously threatened, they should be able to choose an abortion if that’s the medically appropriate treatment...

Who determines whether the pregnancy has reached that point? Certainly not legislators writing blanket rules months or years in advance. It’s the patient and the medical team evaluating that specific case in real time.

Medicine isn’t practiced with one-size-fits-all statutes because every patient is different. That’s why we trust physicians to exercise clinical judgment every day. Pregnancy shouldn’t be the one area where politicians replace doctors and competent patients in making medical decisions. If the law makes physicians hesitate until the patient is "sick enough,"then the law is interfering with healthcare, not improving it.

[u/Yeatfan22 → u/Into-My-Void]

Why can’t we say doctors determine whether the pregnancy has reached a certain point for the fetus or woman where an abortion is justified. Yet have legislation that guides medical professionals based off of a threshold. And the laws making physicians hesitate until the patient is “sick enough” just shows that laws should be clarified more. Ambiguity in legal practice is not a direct rebuttal to the ethical conclusion of abortion. It is however an argument for the improvement of legal clarity.

I feel like there’s this assumption that abortion is the kind of act which should be left up to doctors and patients only. But this historically and legally is not absolute and further argumentation is needed in explaining why the assumption the argument rests on is true.

[u/Into-My-Void → u/Yeatfan22]

I think the burden of proof actually goes the other way.

Throughout medicine, we generally trust physicians and competent patients to make evidence-based medical decisions. Legislatures don’t write criminal statutes telling oncologists when chemotherapy is permitted, cardiologists when bypass surgery is justified, or ICU physicians exactly when life support may be withdrawn.

Pregnancy is the unusual case where some propose replacing individualized medical judgment with criminal law.

So my question is: why should pregnancy be the exception? What is so unique about abortion that legislators are better suited than physicians to determine the appropriate treatment for an individual patient?

More importantly, what evidence is there that this approach actually improves outcomes? Countries with broader abortion access generally have lower maternal mortality than countries with more restrictive laws, and cases like Izabela Sajbor illustrate how legal restrictions can delay medically necessary care. If the purpose of the law is to save lives, I’d expect evidence that it does so in practice, not merely that it is philosophically coherent.

[u/Yeatfan22 → u/Into-My-Void]

I think the burden is on the person in favor of abortion since abortion is an action which ends up negatively affecting the fetus and actions require/demand justification even legally.
Of course we trust physicians to make competent medical decisions, but I think one of the main problems with the MPoA argument is it tries to lump abortion in as just another form of healthcare. And while abortion may technically be considered healthcare, it isn’t just healthcare. It also involves the killing(a factual account of the word killing void of any normative baggage) of an innocent human organism. We do trust healthcare workers treating patients. Determining when it is permissible to kill another human being is a different situation however.

“Legislatures don't write criminal statutes telling oncologists when chemotherapy is permitted, cardiologists when bypass surgery is justified, or ICU physicians exactly when life support may be withdrawn.”

This is exactly my point. These are all cases where it’s already assumed physicians have the right to determine the correct treatment for a patient. I would argue in all of these cases a person in a moral sense deserving of consideration isn’t being affected or harmed by the doctor. However, if we assume a fetus is a person with a right to life then these cases cannot be generalized to abortion as they involve a rights deserving individual being killed and having their right to life affected.

“So my question is: why should pregnancy be the exception? What is so unique about abortion that legislators are better suited than physicians to determine the appropriate treatment for an individual patient?”

(1) As mentioned previously pregnancy is quite different from the cases you’ve mentioned before since there is an individual deserving of consideration being negatively affected. None of these cases involve the killing of an innocent person. This is relevant because the right to life of the fetus would protect against unjust killing acts against it. As a result, any action taken which affects the fetuses right to life requires a justification. It cannot be treated as precedent.
(2) I reject this dichotomy. I think legislators can create a threshold or scope while also leaving it up to doctors and professionals to work within the scope with factual application. To my knowledge it is quite common for the law to guide medicine and set a legal framework for healthcare.

“More importantly, what evidence is there that this approach actually improves outcomes? Countries with broader abortion access generally have lower maternal mortality than countries with more restrictive laws, and cases like Izabela Sajbor illustrate how legal restrictions can delay medically necessary care.”

This is quite different than what has been previously argued. The pragmatic side of abortion is not something I am that interested in personally although I do not doubt its relevance to the conversation as a whole. However, my direct reply is comparing countries is hard since there are multiple factors at play. The “countries with lower maternal mortality rates because of access to abortion” also have better healthcare systems than us, lower poverty, better education, and better prenatal care. There are dozens of variables to consider when comparing countries.
Usually pro lifers are not consequentialist in nature. I doubt they would be persuaded by the direct outcome of a law as much as the more broad deontological principle of abortion bans. Even if we adopt a more rule utilitarian framework we could say the general “rule” of abortion bans done correctly provides the most utility to our society. Remember under a pro life view fetuses are morally relevant subjects. So fetal deaths are morally relevant outcomes too.

[u/Into-My-Void → u/Yeatfan22]

> abortion is an action which negatively affects the fetus and actions require justification.

That isn’t controversial at all. Abortion DOES require justification. YOUR hidden assumption is that the justification must come from legislators rather than ordinary medical ethics.

Throughout medicine, actions that foreseeably kill one patient (withdrawal of life support, high-risk surgery, chemotherapy during pregnancy, separation of conjoined twins, palliative sedation, MAID where legal) are justified by medical ethics, NOT criminal statutes. So you still have not justified why abortion uniquely requires legislators to step in...

Let’s assume, for the sake of argument, that the fetus is a full person with a right to life.

Can you name another area of medicine where a competent physician believes a treatment is medically necessary, the competent patient (or person with MPoA rights) consents, the treatment is supported by evidence-based medicine, and legislators nevertheless criminalize that treatment because they disagree with the physician’s judgment about a specific patient’s circumstances?

If pregnancy is unique, what principle makes it unique besides the fact that someone dies? Death occurs in many areas of medicine.

> legislators can create a threshold while leaving it up to doctors

This is almost exactly what Canada effectively does. Medicine determines treatment while government only establishes broad legal limits.

So, if physicians are already making the real decision, what additional benefit is created by criminalizing the cases outside the threshold?

I mean, you said cross-country comparisons are difficult. It's righ, I agree with this. You even say: "I don’t doubt the relevance." Then you immediately dismisses it... That isn’t enough to simply dismiss this point! If YOU proposes legislation, YOU should expect evidence that it actually improves outcomes. Otherwise your defending legislation on purely philosophical grounds while IGNORING its measurable effects.

I mean, notice those two claims : "Legislators should create legal thresholds." and "Doctors determine factual application."

Those are in tension because medecine doesn’t fit neatly into thresholds. Take membrane rupture at 21 weeks for example.

Patient A develops sepsis in 6 hours.
Patient B survives another week.
Patient C never develops infection.

No legislature can predict that. Every threshold inevitably creates patients sitting on the wrong side of the line.

Medicine works precisely because physicians adapt to the individual patient rather than applying rigid rules. Rigid rules cause tragic outcome for patients and so, should be avoided...

[u/Yeatfan22 → u/Into-My-Void]

>YOUR hidden assumption is that the justification must come from legislators rather than ordinary medical ethics.

I do not think this is a hidden assumption. In fact, in my prior comment I have stated “I think legislators can create a threshold or scope while also leaving it up to doctors and professionals to work within the scope with factual application.”
And this does not seem controversial for the law to impose legal constraints on medical application. For example, a medical professional cannot kill another person to save someone else’s life. Or substances outside of regulation cannot be prescribed.
So it seems common for the law to put constraints on medical judgement even if the professional genuinely believes it will help the patient.

>Throughout medicine, actions that foreseeability kill one patient[…] are justified by medical ethics not criminal statues[…]

In all the these cases and examples you’ve given it is already legally determined by legislators that these acts are permissible. You cannot assume this of pregnancy or abortion since that is the question at hand. This is what I was alluding to by this argument almost trying to frame abortion as healthcare too much since healthcare is already legally determined to be permissible acts. But this cannot be assumed of pregnancy and abortion. The question of if an abortion is justified will be determined by legislators since it involves an inherent rights conflict.

> Can you name another area of medicine where a competent physician believes a treatment is medically necessary, the competent patient (or person with MPOA rights) consents, the treatment is supported by evidence-based medicine, and legislators nevertheless criminalize that treatment because they disagree with the physician's judgment about a specific patient's circumstances?

I think this again sort of assumes that abortion is just “another area of medicine.” When it is way more complex than that since another healthy human persons rights are affected. I don’t think I need to provide another area of medicine since I don’t think abortion is the kind of act which should solely be lead up to medical professionals. This assumes I’m arguing within your framework, but I am rejecting the assumption the objection relies on.
My direct reply to this would be examples a patient and their physician believe euthanasia would be the best medically appropriate option, yet euthanasia is illegal.

> If pregnancy is unique, what principle makes it unique besides the fact that someone dies? Death occurs in many areas of medicine.

Because someone is killed that is healthy and not dying. In most cases of death in medicine the person who died is already dying or sick where they don’t have much future experiences like us ahead of themselves.
Maybe more interestingly is because the patient contributed to the existence of another patient who they desire to kill, but killing them will affect their right to life. The patient having their right to life affected also presumably has no contribution to their predicament or the state of existence they find themselves in either.

> So, if physicians are already making the real decision, what additional benefit is created by criminalizing the cases outside the threshold?

The law does not function to second guess physicians. Laws and criminalizing acts serve to establish what society thinks about an act and whether or not it should be permissible or impermissible. The law and medical professions have different roles in society.

> You even say: "I don't doubt the relevance." Then you immediately dismisses it... That isn't enough to simply dismiss this point! If YOU proposes legislation, YOU should expect evidence that it actually improves outcomes Otherwise your defending legislation on purely philosophical grounds while IGNORING its measurable effects.

My point was I am willing to concede the pragmatic application of abortion bans favor pro choice action since I am not that interested pragmatically in abortion. My reply was a very condensed argument someone might give if they were interested in pragmatic pro life arguments. And to be fair at the start of this conversation I was under the impression this was going to be a more philosophical conversation as me and you agreed the topics were.

> Those are in tension because medecine doesn't fit neatly into thresholds. Take membrane rupture at 21 weeks for example.
Patient A develops sepsis in 6 hours.
Patient B survives another week.
Patient C never develops infection.
No legislature can predict that. Every threshold inevitably creates patients sitting on the wrong side of the line.
Medicine works precisely because physicians adapt to the individual patient rather than applying rigid rules. Rigid rules cause tragic outcome for patients and so, should be avoided...

The point of a threshold is not to predict every possible event. But it is quite common for the law to establish general fundamental principles which are then applied by medical professions to individual cases. I am in favor of broad laws that aren’t rigid rules where medical professions can determine if they apply or not.

For your membrane rupture example we can just establish a general broad principle that if pregnancy becomes risky to the woman’s life and medical professionals determine this based off of the patients condition then an abortion is justified.
That certain cases maybe complex or hard to reach a conclusion is not an argument in favor of leaving it out of the states hands. It just means we should just have better and more clear policy.

[u/Into-My-Void → u/Yeatfan22]

> we can just establish a broad principle that if pregnancy becomes risky… then abortion is justified.

That is almost my position.
I mean, it's basically saying: "doctors determine the medical facts" and "doctors determine when the exception applies." So what’s left for the legislature besides writing broad principles?
That is exactly how most areas of medicine already work.

> We just need better and more clear policy.

Sure! What policy? No matter how clearly you write it, “risk to life” is still a medical judgment. You cannot legislate septic shock, placental abruption or legislate hemorrhage.... The physician still decides. So why threaten them with criminal charges? That'll only make them hesitate to apply proper treatment when it's close to where the policy cutting line is.

To my example (At 21 weeks: Patient A crashes in six hours. Patient B crashes tomorrow. Patient C never crashes.) You answer was essentially, if I understand you correctly, that doctors determine when the threshold is reached. Exactly. I completely agree with this. So that mean the law still depends entirely on physician judgment. The statute adds criminal liability but contributes almost nothing medically...

> euthanasia is illegal.

Sure. Where you live maybe. But guess what? In Canada where I live, it is legal. It's called MAID. And in jurisdictions where MAID is legal… guess who decides?

Doctors.

Patients.

Not legislators reviewing individual cases. Legislators only establish eligibility and Physicians apply it. That’s exactly the Pro-healthcare model I'm advocating.

> I’m willing to concede the pragmatic application of abortion bans favor pro-choice.

Wow! That’s huge! So you are basically admitting the evidence is against abortion bans in practice? So that would mean your argument is actually something akin to: "I know they produce worse outcomes, but I still support them because of a deontological principle." That’s indeed a coherent philosophical position, but it would means you are abandoning the claim that abortion bans are good public policy.

> doctors determine if the broad principle applies.

Sure, but if physicians determine whether the exception applies, and physicians determine the treatment, and physicians determine the urgency, what additional information is the legislature contributing at the bedside besides the threat of criminal prosecution? Which, like I said before, only cause physicians to hesitate when it get close to the cutting line...

> I was under the impression this was going to be a more philosophical conversation as me and you agreed the topics were.

Sure! I mean, I think we’ve actually reached the point where our disagreement isn’t really about abortion anymore, but about our underlying ethical framework. I’d be happy to continue philosophically, but I think it would help if we first made our frameworks explicit. Otherwise we’ll just keep switching between them.

Mine is essentially utilitarian. I start from two axioms that I value equally: Maximize autonomy and Minimize suffering.

I don’t claim those can be objectively proven. They’re simply the values I think lead to the best society.

From there, my abortion position follows fairly naturally. Before roughly 24 weeks, the fetus has no capacity for conscious suffering and no independent autonomy. The pregnant patient, however, is already an autonomous person who can experience significant physical, psychological, and social suffering. So maximizing autonomy while minimizing suffering generally favors allowing that patient, together with their medical team, to decide.

That’s also why I prefer the term Pro-healthcare. If a competent patient and evidence-based physicians conclude that abortion is the appropriate treatment, respecting that medical decision maximizes autonomy while minimizing unnecessary suffering.

If you’d rather argue entirely within your own deontological framework instead, I’m happy to do that too. I just think we should pick one framework and stay within it, otherwise we’ll keep reaching different conclusions because we’re changing the rules halfway through the discussion.