Abortion & Forced Organ Donation

Forced Organ Donation & Abortion

Why I don’t need to agree with forced organ donation in order to believe that abortion is wrong.

The Argument

Forcing a woman to remain pregnant by denying her an abortion is like forcing her to donate all her bodily organs to sustaining another life. Unless you also believe that it’s okay in general to force people to donate their organs to sustain the lives of others, you hold a hypocritical and illogical position and your opinion can be dismissed. If you don’t believe that it’s okay in general to force people to donate their organs to sustain the lives of others, then you have no grounds for then thinking that it’s okay to force the pregnant woman to donate hers to sustain the life of the embryo/foetus.

The Problems with this Argument

1. Firstly, I’m going to take issue with pregnancy being described as organ or tissue donation, when it is nothing of the kind.

  • The pregnant woman does not donate her uterus to her unborn child. The uterus is designed to house the unborn child, and to say that this means that it is donated to the unborn child is akin to saying that a women’s vagina is donated to a man during sexual intercourse, or that a nursing mother’s breasts are donated to her breastfeeding child. An organ used as it was intended to be used by another human being does not constitute a donation.
  • Similar to the above, the pregnant woman does not make a tissue donation of her endometrial lining (which would otherwise be discarded during menstruation) to the unborn child, as this is the intended use of the endometrium.
  • The pregnant woman does not donate her blood to the unborn child. Unlike an actual donation of blood, where the blood is removed from the donor and placed into the recipient, no blood is removed from the mother and no blood is placed into the embryo. Bear with me, because it does get somewhat technical in order to demonstrate this;- Until three weeks after conception, the embryo receives oxygen and nutrients via the trophoblast, which is the precursor to the placenta and forms the outer layer around the embryo. Picture the trophoblast as an eggshell, and and the embryo as the egg yolk. The trophoblast is in contact with lacunae, which are cavities within the endometrium that are filled with maternal blood. Material diffuses from the lacunae through the trophoblast and to the embryo.

    – At two weeks after conception, the embryonic circulatory system begins to form. By three weeks after conception, embryonic blood is moving through capillaries (very small blood vessels) within the chorionic villi, which can be pictured as stalks sprouting from the layers surrounding the embryo. These villi project into the lacunae, and material diffuses from the blood in the lacunae into the embryonic blood vessels, where it is circulated via the embryonic cardiovascular system, which – by the end of the third week – includes a beating heart.

    – The pregnant woman does not donate her body to the unborn child. Her body systems do work together to provide nutrition and shelter for the unborn child, but to claim that this is akin to organ or tissue donation makes no more sense than claiming that my use of my body to provide nutrition and shelter to my three born children is akin to organ or tissue donation.

2. It doesn’t take into account the relative rights at stake. By this I am saying that it fails to recognise the difference between not acting to save a life (non-organ donation) and acting to end a life (abortion). It is important to realise here that my stance on abortion is based primarily on the concept that the unborn child, as a human being, deserves the same human rights as the rest of us.

The key right here is the right not to be arbitrarily killed. Other rights of the unborn child are also violated by abortion, but this one is the most outstanding. However, refusing to donate an organ does not result in the arbitrary killing of the ill individual. We have a right not to be killed; we do not have a right not to die. The most relevant right for the individual requiring an organ transplant is the right to health, but this only covers a right to ethical treatment, and so does not cover forcing another person to undergo a intervention in order to acquire treatment.  Therefore no rights of the would-be organ recipient are violated by a refusal to donate.

3. It minimises and trivialises the bodily autonomy of the unborn child while elevating the bodily autonomy of born human beings, including the pregnant women. Let me illustrate what I mean;

  • A person dying of kidney disease MAY NOT violate the bodily autonomy of another in order to save their own life, even though death may considered one of the most drastic of consequences.
  • A pregnant woman MAY violate the bodily autonomy of her unborn child in the most extreme manner in order to avoid the continuation of her state of pregnancy.

So, on one hand we say that bodily autonomy is so important that we may not violate it even to save our own lives. On other hand, we say that bodily autonomy is so unimportant that we can violate it drastically in order to not be pregnant. The only way to escape this illogical conclusion is to argue that the unborn child does not deserve human rights – and I’ve yet to see one convincing argument on this presented to me.

4. It fails to mirror the state of pregnancy in its analogy of forced organ donation. Even if we were to ignore that pregnancy is not organ/tissue donation (see point 1) and pretend instead that it is in some way, it still does not resemble the organ/tissue donation that takes place between born human beings. For example, if I am pregnant, than the embryo or foetus is already using my uterus; the ‘donation’ has already taken place. The only way to stop the foetus using my uterus is to forcibly remove them, at the cost of their life. Likewise, after a kidney donation has taken place, the only to stop a donor recipient from using my kidney is to force them to undergo a surgical procedure and reclaim my kidney from their body. Regardless of how my kidney ended up in their body to begin with – forced, voluntary or as a foreseeable consequence of my own actions – most people would see that this remedy for reclaiming my bodily autonomy is not sufficiently justifiable.

5. It fails to recognise that that granting a right does not grant every remedy to that right. I have a right to bodily autonomy, but I may not pursue any avenue that I feel is appropriate to exercise that right. To give an example, if I overheard a plan to kidnap me and forcibly remove my kidney in order to give it to the child of the main conspirator, and I know that the only way to stop this from taking place was to kill the unknowing and essentially innocent child, am I justified in doing so? I am not, even if this is the only remedy available that will uphold my right to bodily autonomy.

6. It doesn’t differentiate between an active violation and a denial of intervention (e.g. operation to remove donor organ versus denial of abortion procedure). A doctor needs to meet a high bar to treat a patient without consent (example here), but a much lower bar to refuse to treat a patient (example here). An example in my own personal experience has been an elderly and demented female patient with a cancerous lesion in her gastrointestinal system. Should the surgical team discover spread of the cancer or other complications, they are well within their rights to refuse to perform surgery on this lady. However, they cannot decide of their own accord to perform surgery on her; not without the consent of the relevant family members.


The Challenge of this Argument

It was put to me that it is immoral to refuse to save a life when it is within your power to do so. I am inclined to agree somewhat with this, so how can I then defend myself from being called hypocritical when I fail to advocate for forced organ donation, but advocate for so-called forced pregnancy?

The answer is that it doesn’t matter if I think refusing to donate an organ is immoral. For the above reasons listed, this argument is as relevant to pregnancy as suggesting that because I think lying is immoral, but don’t advocate for legislation banning it, I don’t have a right to advocate for the banning of abortion.


Conclusion

Consideration of the unique situation of pregnancy, awareness of the affected rights of all individuals involved in both pregnancy and organ donation and recognition of the very significant differences between organ donation and pregnancy have led me to the conclusion that this argument, although seemingly relevant and powerful on the surface, can be refuted when it is thoroughly explored


I found the following links useful:

Debunking the Pro-Choice Argument, Part VI

Standford Students for Life: the Kidney Donation Argument

Information on embryological development came from ‘The Developing Human: Clinically Orientated Embryology, 9th Edition’ Moore et al. 2013

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Author: Elizabeth

I am in my mid thirties, a medical student and mother to four amazing little girls. My first venture into pro-life writing was when I wrote an essay on abortion in high school, but I didn't become passionate about protecting the unborn until after I had my first daughter in 2010. I hope my writing will help those who have questions about abortion, and help to build understanding of the arguments surrounding abortion.

26 thoughts on “Abortion & Forced Organ Donation”

  1. For #5, why do you feel you would be unjustified in killing the future recipient of the forced organ donation to save being forced to undergo a procedure?

    1. #5 is meant to illustrate that the provision of a right does not mean that any and all action can be taken to preserve or enact that right. If you feel that my given example is not sufficient to make this point, consider more extreme ones – perhaps the only remedy to the forced organ donation is to kill the surgical team of doctors and nurses who would otherwise be forced to perform the surgery. Perhaps it’s to blow up the hospital where the surgery would take place. Perhaps the only way to kill the child is to bomb their school, killing or maiming dozens of other students. You can be as extreme as you like; at some point you have to concede that the necessary action becomes unjustifiable.

      If you are more interested in likening the situation in #5 to the specific situation of abortion, I suggest you hang around and watch out for an upcoming post on abortion as self-defense.

  2. First, I just recently discovered your blog. I have glanced at all your past posts, and I hope to get back to some or all of them at some point to read them more carefully and perhaps make some comments.

    In the case of this present post, I have read somewhat carefully. While I feel that some of your points might benefit from some further analysis, overall I appreciated the post very much and got some help from it in my thinking about this organ-donation argument. But once again I will not get into any “further analysis” of your points at this moment.

    I would like to set out here what I think would be the most genuine way in which I might myself take issue with the organ-donation argument, and ask what you would think about it:

    1. I agree with the moral principle “No one should be legally compelled to donate a kidney for the sake of another.”

    2. This moral principle of mine is based on a pre-logical moral intuition of mine.

    3. The above example of how I have arrived at a moral principle, together with many similar examples of how people arrive at moral principles, shows the primacy, in moral investigations, of direct pre-logical moral intuitions about specific situations.

    4. Having established the primacy of direct pre-logical moral intuitions about specific situations, if I now look at the specific situation of a woman whose risk of grave loss of well-being in pregnancy is small, and at the idea of illegalizing abortion, my related intuition dictates the moral principle “A woman whose risk of grave loss of well-being is small should be legally prevented from killing her unborn child.”

    You may object that someone else’s intuition regarding abortion may differ from mine. Certainly, many people’s do. I did not say that I would set out here what I think would necessarily be the most effective way, with all kinds of people, to take issue with the organ-donation argument; I said I would set out here what I think would be the most genuine way in which I might take issue with that argument. I have set out the way in which my mind actually works.

    I have been nudged toward my present intuition about abortion by your logic and analogies on this page, as well as by logic and analogies coming from both sides that I have heard over the years. But at the end of the day, what governs for me is my pre-logical intuition, whose provenance I don’t completely understand, and not any logical proof.

    I wrote that my 4 points above were not necessarily the most effective way, with all kinds of people, to take issue with the organ-donation argument. But who knows what would be effective with some people? Just a few minutes ago, I saw where Albany Rose had asked on her Facebook page, “What do you feel are some of the strongest pro-life arguments? What do you feel are some of the weakest pro-life arguments?” Rebecca Kiessling replied: “Proven strongest in studies: real stories to humanize the child. Weakest: scientific, philosophical, statistics, which keep the child theoretical.”

    1. Sorry it’s taken me so long to reply to your comment. I’ve enjoyed reading what I have of your thoughts on moral intuition. I do appreciate what you have laid out as a very genuine and sincere way to respond to this argument. And I think it’s a useful way to approach a discussion on this argument, i.e. discover what their belief regarding forced organ donation is based upon, and then move from there onto where those beliefs apply to abortion. For example, if someone responds that forced organ donation is ‘just wrong’, then they lack grounds to dismiss your moral intuition that abortion in the circumstances of minimal risk is ‘just wrong’. If they consider it to be question of violation of rights, then that gives an excellent starting point to discuss the application of human rights in the scenario of abortion. Et cetera.

      1. Thanks for your reply.

        First, a question about what “that” in your last sentence refers to. It seems to me that you could be saying either:

        “their considering it to be question of violation of rights gives an excellent starting point . . .”

        or

        “their responding that forced organ donation is ‘just wrong’ gives an excellent starting point . . .”

        Probably you mean the latter, which would be the approach that I would consider most productive — to start by letting each person look closely at their pre-logical moral intuition.

        I certainly wouldn’t want you and other pro-lifers (or me) to slacken our efforts to refine logical arguments, but I think that when we use those arguments we should be clear about their actual role in the changing of views.

        Around the time that I first commented above, I wrote a new blog post —

        http://www.NoTerminationWithoutRepresentation.org/moral-intuition-logic-and-the-abortion-debate/

        — focusing on the roles of logic and of intuition, not on abortion. I hoped with that post to start some discussion about the roles of logic and of intuition, and about how better clarity about those roles might change the way we debate. For instance:

        “I would like to see a discussion between the parties on both sides of any issue — say between a pro-choicer and a pro-lifer — a discussion that begins with each party examining their own intuitions and related feelings. . . .

        “Then each party would try to describe those intuitions and physical-emotional feelings to the other party. . . .

        “Then the two proceed to discuss the violinist, the Cabin in the Blizzard, the “John” thought experiment, etc., at each point reporting ‘This makes me feel such-and-such deep inside.’ . . . .”

        “At the end, each will again examine and report their direct intuition about pregnancy itself. . . .”

        Just the other day I started listening to a podcast —

        http://www.samharris.org/blog/item/the-very-bad-wizards-interview-1

        — that is about morality issues (not specifically about abortion). I was struck by the bio of one of the participants —

        “His primary research interest is in how and why humans make moral judgments, such as what makes us think certain actions are wrong, and that some people deserve blame. In addition, he studies how emotions influence a wide variety of judgments”

        — and by a quote, elsewhere than that page, from another of the participants —

        “It’s foolish to expect people to be morally persuaded of anything through reason alone. If you want to truly make a difference you must use emotion to trigger an empathy response within the subject. Anything less and most will simply look at a perfect argument and discard the conclusion, no matter its strength.”

  3. Hi Elizabeth! Is this the post you referred to during our last discussion at SPL?

    I have problems with all your problems. But in order to keep the comments relatively short, I’d like to focus on one thing at a time. Though I am avoiding vulgar language, it is still possible that some of what I say might strike you as being vulgar. Please understand this is not my intent.

    You deny that the pregnant woman donates her uterus to the prenate because the “uterus is designed to house the unborn child.” But you fail to say why that matters. It doesn’t matter what something is designed for, what matters is who has a claim to it. You seem to be saying that because the uterus was designed to house prenates, the prenate has a right to the uterus. But one does not follow from the other. Houses are designed for people to live in, but that doesn’t necessarily mean you have a right to my house. If I let you live in my house one is justified in saying I have donated my house to you.

    Again, your vagina is designed for sexual intercourse, but this does not mean that I have any right to use it. If you let me use it, then one can justifiably say you are donating it to me. But if I were to use it without your consent, I would justly be charged with rape. And I couldn’t defend myself by saying, “Well, that is what your vagina is designed for!” Why? Because, whatever your vagina is designed for, it is still *your* vagina.

    1. It’s one of the posts. I haven’t been in the right headspace to write much lately.

      You mistake my intent. The post is intended to illustrate the points of difference between pregnancy and organ donation that make the comparison moot. It is not intended to lay out reasons why the prenate might or might not have a claim to utilise a woman’s uterus. The fact that the uterus is physiologically designed for the use of the prenate, but my kidney is not designed to be removed from my body and housed in the body of another person is a point of difference.

      1. What I don’t understand is why that makes a difference. The basic concept behind the argument remains the same: Whether you donate an organ or carry a pregnancy, you are giving your body parts over to the use of another. That one is accomplished through natural means and the other is accomplished through artificial means just doesn’t seem relevant.

      2. The basic concept behind the argument is that there is a direct comparison between forced organ donation and pregnancy, and therefore one cannot be against one and for the other – unless one is a hypocrite. The failure of this direct comparison means that the argument is no longer valid. You can argue that a woman should not be required to use her body to continue to sustain the unborn child once conceived, but you have to do so without bringing forced organ donation into the picture.

        What is the uterus intended for? It is is intended to enable a female to sustain a child. Her own body is using its own organ within itself to achieve its intended purpose. It serves not only the unborn child, but also the female (from a physiological point of view). To look at it as a donation only makes sense if you ignore the fact that the woman’s body is using its own organs to achieve an end.

        As has been pointed out by others, if you extended the idea that body parts remaining in place can still be considered to be donated, then anything we do that serves another could be considered an organ donation, as our internal organs work together to enable our body function and therefore our actions.

        I’d further point out that I’ve never heard rape referred to as ‘forced organ donation’, despite the fact that a part of the woman’s (or man’s) body is being used for the purposes of another against her or his will.

  4. In reply to Elizabeth, 1201 8 January 2015–

    But the point of the comparison is that a part of the person’s body is being used for the purpose of another against their will. “Forced organ donation” is certainly an oxymoron, but the concept is the same. The relevant factors of the comparison are “your body” and “your will.” The body part’s “intended use” just seems irrelevant on its face. And you still haven’t said why “intended use” makes a difference to the questions of whose body it is and who has a right to use it.

    Yes, in a wanted pregnancy, the woman is using her organs to achieve an end, in this case having a baby. That is no different from either donating an organ or having sex; in both, the person is using their organs to achieve an end. But when the pregnancy is unwanted, it certainly does not serve the female. If she doesn’t want a baby, then forcing her to gestate does her great harm, both physically and psychologically. This is no different from forcing someone to give up their organs or have sex.

    This is what I’m trying to understand here. You’re certainly not the first person to bring up the “intended use” of the uterus. The question I am asking is what difference does it make to a discussion of “your body” and “your will.”

    1. The point of the comparison is to try to trip up the pro-lifer in a supposed contradiction.

      I haven’t addressed ‘intended use’ and a right to use because that was never part of what I was talking about in the post. I feel like I’m repeating myself, but when someone’s own organ is being physiologically utilised within their own body, it is not being donated. That is the material point. It is why the violinist, where the person’s body is being used, but the specific organs involved are not donated, a far more apt comparison than forced organ donation. It, along with my other points, also renders meaningless the conclusion that those who are against abortion must logically be for forced organ donation.

      “That is no different from either donating an organ or having sex”

      I kind of feel like I just wrote a whole blog post explaining why it is different to donating an organ.

      1. Okay, I think I’m getting closer to understanding your point, though I think you’ve just mooted the “intended purpose” part of your objection.

        What I’m still having trouble understanding is why the point is material to what is being compared. Whether in the body or not, what is being compared is who the organ belongs to and who has the right to decide who gets to use it. That is what people making the comparison are trying to establish. It seems to me that unless you somehow address the points that *are* being compared, the differences between pregnancy and “forced organ donations” are irrelevant.

      2. You can use it as a comparison to explore a general principle, I agree with that. But what I see is the insistence that it’s a literal comparison, i.e. pregnancy IS forced organ donation, or an accusation of hyprocrisy, e.g. if you’re against abortion, then you can’t object if someone takes your kidney without your consent. To distill my post down to two points, 1. pregnancy is not literally forced organ donation, and 2. you can object to abortion AND forced organ donation without being a hypocrite.

        I certainly don’t feel that I mooted any point I made regarding intended purpose, so long as you’ve moved past the idea that I was trying to use it to establish that the unborn child has a right to use the uterus – an argument which, to the best of my knowledge, I have never attempted to make.

      3. Generally speaking, I talk about inconsistencies rather than hypocrisy; if I’m going to say hypocrisy, I’m going to build a case for it. OTOH, I do think that forced gestation is tantamount to forcing someone to give up their organs to another. The apparent cornerstone of your argument that it is not appears to be because of the “intended purpose” of the organs. And you are still not clear why that makes a difference to the comparison that is actually being made.

      4. One of the cornerstones of one of my points, which challenges that pregnancy is literally organ donation, is that an organ being used in situ for its physiological purpose is not being donated. My kidney filtering my blood inside my body is not being donated. My small bowel digesting food inside my body is not being donated. My uterus gestating my child inside my body is not being donated. If you accept that pregnancy is not literally an organ donation, even if you think it is comparable to one, then we don’t actually have a disagreement on this point, since I am talking about the biological reality rather than the philosophical implications.

        I feel like I’m unable to clarify this in a way that satisifies you, and also that we’re tracking around in circles.

  5. “I am talking about the biological reality rather than the philosophical implications.”

    If we were to talk about the philosophical implications, I would say that the naturalness and the in situ reality, per se, of the temporary use of one’s uterus do not imply that the imposition of use of the uterus is morally more acceptable than the imposition of loss of an organ.

    However, knowing what we know in general about nature’s finding ways to ensure the safety of normal bodily functions, the naturalness and in situ reality do imply that any harm caused by the use of the uterus in pregnancy will be minimal compared to the loss of an organ. The next step is to see if this is borne out empirically.

    As a small start in looking at the empirical evidence, I think it’s true that many women have maintained reasonably good health after two or even more pregnancies and deliveries, but no one has maintained their health after two kidney donations or one heart donation.

    And it seems to me that the degree of actual harm to each of the two principal parties involved has more profound moral implications in the abortion debate than any other single factor.

    1. Without modern medicine, as many as one in ten women died from pregnancy or childbirth. That casts a lot of suspicion on just how much the naturalness of the uterus’ use will be minimal. Even so, one could simply focus on parts that regenerate, such as blood, marrow, or the liver. In the case of blood and marrow, people can and have maintained reasonably good health after more than two donations. But we still don’t force them to do it. And of course the dead don’t need even their hearts anymore, but we don’t force the dead to give up anything either.

      Before discussing the degree of actual harm to the principal, we would have to have an agreed upon means of assessing said harms.

      1. “In the case of blood and marrow, people can and have maintained reasonably good health after more than two donations. But we still don’t force them to do it. And of course the dead don’t need even their hearts anymore, but we don’t force the dead to give up anything either.”

        Proposing unborn child-protection laws where they do not already exist assumes in the first place that some present laws are ill-conceived.

      2. And . . .

        “Without modern medicine, as many as one in ten women died from pregnancy or childbirth. That casts a lot of suspicion on just how much the naturalness of the uterus’ use will be minimal.”

        . . . without modern medicine, how many kidney donors out of ten would have died?

      3. “consistency would demand also taking care of the presently ill-conceived laws, don’t you think?”

        Yes. Are you suggesting that I’m not trying to reform the blood / bone-marrow laws?

  6. Are you familiar with Kristine Kruszelnicki’s approach to pro-choicers’ forced-organ-donation analogy? If not, I recommend it:

    http://www.prolifehumanists.org/unwanted-pregnancy-forced-organ-donation/

    “Sometimes parents need to use their bodies to care for their dependents. . . . Just as a parent must wheel or carry an infant everywhere they go, because the infant’s level of development doesn’t allow them to walk independently, so too a fetus will place more demands on his/her parent because of his/her age and developmental stage. It so happens that pregnancy is the only way to feed, shelter, and protect developing members of our species when they are at their very youngest and weakest.”

    I think her approach takes us close to the door of a correct moral intuition about the matter. I would say as usual that in order to pass through the door and feel the intuition, feel that something matters, we have to leave logic behind. It is only the intuition that says, “Something matters,” not the logic.

  7. Elizabeth, I see a lot of people raising very good points about how your analogies are sometimes incomplete or becoming contradictory when further explored. You usually respond with “That isn’t the point, the point is to demonstrate the difference…” or “That was meant to illustrate…” Both of those kinds of responses are evading a major issue: if your analogy is only appropriate or useful to your argument when the scope of its implications are rigidly and tightly curated by you, then the analogy isn’t really a good one after all. If you have to skip back and forth between “It’s about autonomy of one body versus another” and “It’s about the most literal analysis of terms like ‘donation'” etc, etc, it doesn’t inspire confidence. It reads more like you’re cherry picking when to apply X principle and when to apply Y principle instead.

    I know this comment doesn’t give you much to directly respond to, I’m just trying to get across that your curation of an analogy’s implications are not the only ones, and when someone raises other ones you should listen, consider, and respond to them, rather than simply talk past them by re-asserting your original, narrow use of the analogy.

    1. Thank you for your thoughts, Esther. I’ll keep this brief, because I’d prefer to conduct conversations via a one-on-one format, such as email.

      It is difficult to respond to what you have said because you don’t give me specifics, but what I feel able to say is this;

      An analogy is intended to represent a situation in a way that enables the reader to draw a intuitive conclusion. If this analogy does not match the situation as tightly as possible, the conclusion becomes at best questionable, at worst invalid. Many, many analogies have been created in the debate over abortion, and I have observed many that mislead because they fail to take into account relevant aspects of the issue. Hence I take considerable time thinking through the analogies I use, to try to have them reflect reality as accurately as possible. This isn’t an attempt to be dogmatic; rather it is an attempt to be accurate. And this is important because of the implications it has for the conclusions one might draw from the analogy.

      I am very happy to continue this discussion via email. You can use the contact page to get in touch with me.

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