Beyond the Abortion Wars: A Way Forward For a New Generation by Charles C. Camosy. Eerdmans. 224 pages (to be released March 12th 2015)
In his forthcoming book Beyond the Abortion Wars, Charlie Camosy has once again produced a fine piece of scholarship that moves beyond the technical and insular debates of the academy and speaks to a wide audience on a matter of pressing importance. Camosy should be commended for his courage on tackling such a controversial and polarized issue, and he does a marvelous job (as befitting his reputation) of cutting through the ideology of either a pro-life or a pro-choice stance to find common ground that the majority of thoughtful Americans could stand upon. But as is the case with Camosy’s other scholarship, individuals on all sides of a debate should be prepared to be challenged. Camosy does not ever demonize his opponents; rather, he listens carefully to learn from them. His position is an uncompromising pursuit of truth, even when it means challenging cherished preconceived notions.
As such, this is a pro-life book but one that refuses to dismiss pro-choice reasoning, opting instead to integrate the concerns of pro-choice advocates (authentic feminist concerns like reproductive health, life of the mother, social structures that support childbearing women and young children like paid maternity and paternity leave, healthcare, job protection, etc.) without sacrificing the rights of an incredibly vulnerable population: prenatal children. Another strength of the book is its wide audience, and Camosy has proven himself a scholar capable of communicating sophisticated and technical arguments that make moral theology so daunting in ways that make his writing accessible to the untrained.
This is a thorough book. Camosy begins with the state of the political discourse, focusing on the bizarre ways in which our political parties betray their own most fundamental values on the abortion issue (humorously called the Costanza strategy whereby mostly libertarian Republicans adopt a position of strong federal intervention into people’s private lives and mostly humanitarian Democrats end up ignoring the most basic rights of the vulnerable prenatal population). From there he moves into arguing that the fetus is not simply a part of a woman’s body but a human person with actual rights. This chapter has the potential to get bogged down in abstract philosophical speculation but Camosy does a good job keeping it accessible. His arguments are straightforward. While dependent on the mother’s body, the “prenatal child is a different and self-organizing animal.” That the fetus is a person is already reflected in our laws (which can lead to a double homicide conviction for the murder of a pregnant woman) and our language as when people refer to being “with child” or feeling the “baby” kicking. Camosy rightly notes that “resistance to calling a fetus a person is often less about what one believes about the moral status of the fetus and more about what one believes about the rights of women” which he addresses in a later chapter (57).
The third chapter is the most technical and most important. Here Camosy distinguishes between direct and indirect abortion, aiming to kill and refusing aid, and clarifies what the word “innocent” means in the universal prescription to not kill the innocent. Camosy is explicit that though the fetus is a person with rights, it ought not to be given more rights than non-fetal persons. He rightly points out that when another person is a direct threat to one’s life, they may be attacked and even killed in self-defense. Even when the attacker is “innocent” (a six-year-old child soldier who has been brainwashed, say) they can still be killed in self-defense. This is not a violation of the principle to not harm the innocent, argues Camosy, if we distinguish between formal innocence (that is, in essence not responsible for their actions as the fetus always is) and material innocence (meaning perhaps non-threatening). Thus he argues that it might be possible for a pregnant woman to use deadly force (even a direct abortion) when the fetus is directly a threat to her life, assuming that this direct attack on life is a last resort. In this way, Camosy carves out a way to protect the life of the mother in those rare cases which may demand a direct abortion. Camosy admits that situations such as this will be incredibly rare but may occasionally arise. On this point, he will undoubtedly face opposition from pro-lifers but this argument in particular is a compelling one to me. More controversial is his treatment of RU-486 which I will address in more detail below. Because of the complexity of this chapter and the number of distinctions Camosy needs to make, I kept wishing it had been split into two chapters with more detail given to each leg of the argument. However, Camosy was explicitly trying to avoid getting bogged down in argumentation that would have excluded much of the broad audience (most of them non-specialists) he was intending to reach.
In chapter four, Camosy addresses the challenges of moving from moral argumentation to public policy. Here Camosy tackles complicated arguments about whether criminalizing abortion would (a) be effective in protecting prenatal life or (b) possibly cause more harm than good. He makes strong arguments in favor of the former and against the latter by drawing on what fragmentary data we have of the pre-Roe era and by making comparisons between our country and Ireland and Poland whose abortion laws are more restrictive. Camosy makes a compelling (even if not particularly strong due to lack of clear data) case against those who argue that criminalizing abortion will lead to huge numbers of women dying from back-ally abortions. He writes, “Abortion became the relatively safe procedure it is today well before it was legalized, primarily due to improved medical technology and the fact that well-trained physicians are the one who do the overwhelming majority of illegal abortions.” This is a foundational chapter for the piece of legislation Camosy proposes in the final chapter which criminalizes most abortions.
The penultimate chapter was my favorite by far in which Camosy makes his strongest arguments in favor of a pro-life feminism. He draws heavily on the works of Sidney Callahan here in establishing that abortion has served the interests more of men and male-established social structures than it has of women. He argues that the
“Roe court sought a solution that made women ‘free’ to act like men: to imagine themselves as able to live sexual, productive, economic, professional, and parental lives and confers as men did. On this model, pregnancy and childbirth are a burden and cause of distress relative to one’s economic gain, professional advancement, and sexual autonomy. . . . But being pregnant and having a child is often so burdensome for women precisely because our social structures have been designed by and for human beings who cannot get pregnant.”
This chapter is also important towards the goal of proposing an actual piece of legislation in that Camosy recognizes that making abortion illegal cannot be separated from concerns about justice for the women who bear the prenatal children we are trying to protect.
The final chapter is unique, courageous, and difficult. Camosy is commendable both as a scholar and as a person in that he is moved to action based on moral arguments he finds persuasive. Thus, he concludes what is already a brave piece of scholarship with the even braver—and more brazen—move of proposing legislation, the Maternal and Prenatal Child Protection Act (MPCPA). Camosy wants to make clear that his proposal is both (a) consistent with public opinion and (b) consistent also with the settled doctrine of the Roman Catholic Church. On both points, he will face significant disagreement.
Perhaps the most controversial point (from the pro-life perspective) of Camosy’s plan pertains to his discussion of RU-486. Camosy argues that RU-486 constitutes an indirect abortion and might better be “described as refusing to aid rather than killing” (146). His starting point here is the established reasoning that certain procedures that result in the death of the fetus are indirect abortions, not direct attacks on life, and can be justified by serious proportionate reasons. For example, a pregnant woman with cancer of the uterus may have a hysterectomy which results in but does not aim at the death of the prenatal child because of a serious proportionate reason (protection of her life). The hysterectomy is justified because it is not a “direct and deliberate” killing as opposed to suction which would constitute a direct abortion (even if done for proportionate reasons). As Camosy notes
First it [hysterectomy in the case of cancerous uterus] is an indirect abortion that is not aiming at the death of the child: the death of the child is neither the goal nor the means by which the goal is accomplished; indeed the mother would be overjoyed if the child survived the procedure. Second, there is a proportionately serious reason for permitting (though not intending) the death of the child: the mother’s life is at serious risk.
What this paradigm case illustrates is that it is not always easy to identify the object of the action in question because every object involves a certain degree of intentionality (which is internal to the agent). Thus, while it is always impermissible to do evil (even when a great good will come of it), it is not always clear what a great evil is.
Camosy illustrates this with another case: A 21 week old prenatal child is diagnosed with a terminal illness whereby it will die either in utero or shortly after birth. The parents request induced delivery as soon as possible in order to baptize the baby, cuddle and hold him, attempt to feed him, etc. Does induction (which will almost certainly result in the imminent death of the baby, constitute a direct attack on life? It is a difficult case, one that Camosy admits makes “pro-lifers” nervous because here it is not clear what the object of the action is. I am inclined to agree with Camosy that such an action should not by any means be called a direct attack on life (and thus, a direct abortion), but among pro-lifers there will not be consensus on this point.
Nevertheless, Camosy proceeds to reason that in the case of RU-486, it operates differently from a direct abortion in that in its very nature it does not attack the growing fetus but rather acts to make the uterus hostile to the fetus by interrupting the natural balance between progesterone and prostaglandin. It is important to Camosy the way RU-486 works as a drug in that the prenatal child is never directly attacked but rather that the essential hormones the prenatal child needs to survive are removed. Indeed, the term contragestion (contra- gestation) has been proposed to describe the unique way the RU486 operates. Thus, in his reasoning, RU-486 should always be identified as an indirect abortion which may be justified by proportionate reasons, analogous to preterm induction or caesarean.
I disagree with Camosy that administration of RU-486 should be considered in its object as an indirect abortion. The object of the action in taking RU-486 is to kill the fetus by means of making the uterus hostile to gestation. Unlike the hysterectomy which has two clear effects or even premature induction, RU-486 serves the sole purpose of ending the pregnancy. There is currently no other reason to take the drug. The principle of double effect would not apply here because the object of the action itself constitutes a direct attack on life (though the means of attacking life are indirect). Using Camosy’s own “pissed test,” we might reason that the individual taking RU-486 would be pissed if the fetus/prenatal child survived the procedure. The object here is to kill.
While Camosy makes much of the “withholding aid” argument, it is important to recognize that withholding aid can, in many circumstances, constitute a direct attack on life. If I refuse to feed my infant son, who is unable to feed himself, thus resulting in his death, I am still guilty of homicide. I cannot argue that I was just withholding aid rather than physically attacking his person. The means are different but the object is the same. Moreover, proximity is often accompanied by duties that may be unchosen. Say, for example, another infant I don’t know is placed in my home one night while my house is simultaneously isolated from the rest of the world for a nine-month period such that nobody can get in or out. I have enough food in the house for the infant and myself, and nobody else can provide for the infant’s needs during that nine-month period but me. If I refuse to aid the infant under the reasoning that I did not choose to have an infant placed in my home nor did I choose to have the duty to feed him for nine whole months, and the infant died, I am still guilty of homicide. While I think Camosy is right to note that RU-486 functions differently from, say, the suction method of early abortion, I don’t find his arguments convincing at all that the mere fact that RU-486 terminates the pregnancy by denying what the prenatal child needs to survive thereby changes the object of the act. It still appears to me that taking RU-486 constitutes a direct abortion.
Nevertheless, this should be considered a minor disagreement in the overall scheme of his proposed legislation. I read Camosy here as wanting to find a way to make a concession in his pro-life stance in order to match public opinion which is overwhelmingly in support of early abortion in certain cases (life of the mother, rape, incest) and to create a piece of legislation that is politically and legally viable. Camosy’s MPCPA is not a piece of legislation that is going to make anybody completely happy. Like all legislation in a pluralistic society, it is a compromise. Despite the exception outlined above for what I think would be allowing direct abortion in certain cases through administration of RU-486, the rest of the proposal is a thoughtful and realistic attempt to protect prenatal children and the women who carry them. It calls for equal protection of the law for the prenatal child by criminalizing direct abortions after week eight and charging physicians performing such abortions with a Class A felony (except in the case of the life of the mother in which a last-resort direct abortion would be permitted). It calls for support of mothers and their children during and after pregnancy through legislating equal pay for equal work and increased protection for women and mothers in hiring and firing. It calls for universal access to postpartum maternal health care, increased paid pregnancy leave with job protection, two years of prekindergarten, and systematic attempts to make child support collection more aggressive. Finally, it includes funding of public campaigns to de-stigmatize adoption. There is something here for everybody to like and to rally behind, but not without compromise.
As someone who identifies as pro-life, who serves on pro-life committees and marches in pro-life rallies and prays in front of abortion clinics, and as someone who disagrees with the concession built into the legislation to allow for use of RU-486 in certain cases, I would still vote for this piece of legislation. To that end, I think Camosy’s dose of realism to pro-lifers like myself who are one extreme side of the political spectrum is telling:
You may not think that the MPCPA perfectly reflects your view of abortion, but you really should support something like it nevertheless. You should support it because the church explicitly teaches that faithful Catholics may support incremental legislative change if the political realities give you a proportionately serious reason to do so. And if you don’t think our current discourse on abortion the US gives you such a reason, frankly, you need a dose of political reality. . . Though the tide is turning against abortion on demand, it is absolutely not turning in the direction of banning all abortion. There is overwhelming support for abortion choice in the cases of rape and life of the mother. Indeed, over 90 percent of “pro-choicers” support these exceptions, as do almost 70 percent of “pro-lifers” (157).
This is such an important book and should be read widely, by scholars and lay folk alike. It should be read because the issue is pressing and grave: 1.2 million prenatal lives are lost each year. It should be read because it teaches people how to think about an issue as difficult as abortion without relying on sound bites or demonization of one’s opponent. It should be read because it compels us and equips us to move from the arguments to the public square. Finally, it should be read so it can be discussed, particularly with the author whose greatest virtue is his uncompromising, unwavering commitment to truth. Camosy has produced a fine book, but he of all people knows that the conversation is not over. Indeed, it has just begun again, new and refreshed. In this new springtime of the abortion debate, may we be like the author, quick to listen, generous towards our opponents, and above all, committed to finding common ground.
The Catholic Church teaches that the foetus is a human being, but not necessarily a human person (we’re not sure of the exact moment of ensoulment which may well be some time after implantation).
I disagree with the agrument that it can be morally licit to intend to kill a human person (eg a child soldier). However, there are sometimes forms of self defence in which death is unintended although expected.
A more careful analysis of the moral object chosen can be very helpful here eg removing a foetus which will kill the mother is morally licit because removal is not killing – we can often keep such premature births alive; when we cannot that is limitation of our medical technology not necessairily an intent to kill.
I agree that RU-486 seems to be a direct abortion.
Thanks for commenting Chris. I think Camosy is strong on causing the death of the fetus when the mother’s life is at stake but I think you are right to raise the question of object. Let’s take a craniotomy in a developing country where a woman is in labor and the fetus’ head is simply to big to deliver. Assuming there is no safe option for a C. section and the attending physician decides to do a craniotomy, how do we classify that object? As a craniotomy with the unfortunate foreseen but unintended consequence of killing the fetus? As such, could we call that an indirect abortion? Doesn’t it look like the fetus is being intentionally killed to save the life of the mother? And if so, isn’t that a direct abortion?
Or what about a woman at 12 weeks with severe hypertension whose life is directly threatened by the pregnancy, such that the attending physician worries that if the fetus is not removed at this moment, the woman will die. If he decides to remove the fetus via suction, how do we possibly classify that as an indirect abortion?
The question Camosy wants to raise on this point is whether a direct abortion might be allowed in extremely rare circumstances to save the life of the mother? In other words, can we intend to kill (not want to kill, but intention and want here are different) in order to save the mother’s life?
Camosy’s book is already available on Amazon in ebook form. Above and beyond the puzzling attempt to re-classify taking RU-486 as an indirect abortion, I think that Chapter 3 of the book in particular has some quite serious problems.
Chapter 3 is challenging and he has a lot of different distinctions going on for sure, Paul, but what problems specifically did you have in mind?
I found five problems in Chapter 3: a claim that self-defense is conditional on innocence of the aggressor; a claim that a fetus can be an aggressor; a claim that use of RU-486 is indirect abortion; a claim that some direct abortions are legitimate; a vague treatment of indirect abortion.
I’ve written more on these in a blog posting.
Hi Paul. Thanks for engaging on these important issues. But, unfortunately, there were lots of problems with your piece, even acknowledging that all blog posts can generally manage are thin and sweeping reactions to complex arguments.
First, if you are going to criticize my arguments (which I welcome), please do me the courtesy of responding to my stated point of view. I never once use the word “aggressor” to describe the prenatal child who threatens her mother’s life. Indeed, this is a quote from my book: “Because her will is not involved she is not performing an action at all, and so descriptors like “aggression” or “unjust” simply don’t apply to her actions.” Instead, I use the concept of a “material mortal threat.” Maybe you don’t think that deadly violence can be used to defend against a clear and present material mortal threat, but that would put you in a strange relationship with most of the tradition.
Second, your post confuses direct abortion understood as a kind of act and direct abortion understood as intention. An abortion can be direct in two ways. First, it can be direct via the nature of its action–when the nature of the act itself (like a D and C abortion, for instance) aims at death. Second, it can be direct via intention as you suggest. But in your treatment of my argument about RU-486 you miss the fact that such an abortion may not aim at death by intention, and then we are talking about indirect abortion and onto proportionate reasoning. Without argument you then claim that there is no due proportion in the cases I propose. But even if you are correct about this, making a moral mistake with respect to proportionality is not the same as aiming at death. It would not be a direct abortion.
Third, inducing labor is clearly an abortion of pregnancy. And, if it results in an early death of the prenatal child, and the death of the baby is not the object of the act, then it is an indirect abortion. Indeed, if you accept that what was done in that 2009 America magazine case is legitimate, then you admit that there are proportionately serious reasons for doing indirect abortions which go beyond saving the life of the mother.
Camosy: “I never once use the word ‘aggressor’ to describe the prenatal child who threatens her mother’s life.”
I did notice that when I read your book. In an absence of your definition of ‘threat’, I considered two possibilities: that you meant ‘threat’ to refer to something distinct from ‘aggression’, or else that ‘threat’ and ‘aggression’ in your book really amounted to the same thing. Now prior to describing the fetus as a threat, you had pointed out some examples where Catholic teaching allows (possibly fatal) self-defense against aggressors. (The Catechism always refers to aggressors when describing permitted self-defense.) And then you stated: “If one may use deadly force to defend against the deadly threat of an innocent juvenile soldier and an innocent shooter…” But that only applies if ‘threat’ refers to actual aggression. So I concluded that, though it was not obvious, your argument was dependent on ‘threat’ referring to the same thing as aggression.
Alternatively, if your use of ‘threat’ doesn’t refer to aggression, but to something else, then (a) what is the point of giving examples of Catholic teaching about defense against aggression?, and (b) what exactly is this ‘threat’, and where is the Catholic teaching about it?
The definition of ‘threat’ is usually something like: “an expression of intent to inflict injury”, or “possible harm”. In neither case does Catholic teaching simply allow a perhaps fatal self-defense as a response — something more is needed (actual aggression, in fact).
Camosy: “…in your treatment of my argument about RU-486 you miss the fact that such an abortion may not aim at death by intention, and then we are talking about indirect abortion and onto proportionate reasoning. Without argument you then claim that there is no due proportion in the cases I propose. But even if you are correct about this, making a moral mistake with respect to proportionality is not the same as aiming at death. It would not be a direct abortion.”
Let me make my argument in a different, more general, form. Suppose someone is considering performing some specific action which appears to have a good direct effect, A, and a bad side-effect, B. On evaluating the relative good and evil effects, they note that the evil of B is actually much worse than the good of A. If at that point they decide that A is so personally attractive that they go ahead and perform the act anyway, they are now in the situation of intending B — not as an end, but as a means. (I.e. they could avoid any overall evil simply by choosing not to perform the act at all. Instead, they choose to allow the evil of B, since otherwise they don’t get the good of A. That makes B a means. That also makes it intentional. And thus, direct.)
The preceding argument can be applied to the taking of RU-486: the good effect being something like “relief from a burden”, and the bad effect being the death of the fetus. The disproportionate evil ends up being intended (i.e. direct).
Camosy: “Third, inducing labor is clearly an abortion of pregnancy.”
A very common definition of abortion is the ending of a pregnancy before viability. Sometimes “abortion” is additionally used to describe cases where the death of the child is going to occur, even though it is viable. However, simply the fact that labor has been induced doesn’t mean it is an abortion.
Camosy: “Indeed, if you accept that what was done in that 2009 America magazine case is legitimate…”
What was described there was commendable. The parents were thinking of an early induction (i.e. pre-viable), which the Catholic hospital declined to help with. The parents were then persuaded to change their mind, and they decided to go with either induction at full-term, or a natural birth. From the given data, it is not clear which of those two occurred. But no abortion of any kind occurred, whether direct or indirect.
Thanks for your reply.
I suggest that “intent” is what you choose to do eg to remove a foetus or deform a baby’s head so as to try to save the life of both mother and child.
Such an action is obviously morally lict, because it can often be done without causing the child’s death. In those cases where we cannot, due to present limitations on our medical technology, that is an unintended consequance, not an intent.
Removing a foetus is not per se the kind of moral act which kills, or intends to kill.
It would be prefereable not to use suction or craniotomy, but there are many cases in the Third World where mothers facing death do not have the luxury of a whole lot of choice in the methods doctors use to save their lives.