Since I completed the manuscript for this book, colleagues
and students have raised several questions I had not addressed. These questions
involve (1) the logic of the "life of the mother" position, and (2) the
relationship between "life" and "breath" in the Old Testament understanding
of man and its bearing on the question of personhood.
The Logic of the "Life of the Mother" Position
Some suggest that there is an inconsistency in holding to a
presumption of personhood from time of conception and yet allowing for an
exception in the rare cases where continuing the pregnancy would threaten
the life of the mother. If the preborn child is a person in the whole sense,
why should the child's life be sacrificed for the mother's?
One response compares the life-of the mother position to self
defense. The developing child is an "aggressor" whose "attack" may legitimately
be repelled by any means. The problem with this
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analogy is, of course, that the preborn child is hardly a morally
responsible agent in the sense normally understood to require self-defense.
The child is there through no choice of his own. The analogy is obviously
weak.
A better analogy is the "triage" situation. Consider, again,
a physician at the scene of a catastrophic train derailment in an isolated
location, where no other medical assistance is available. The physician must
quickly make a judgment classifying the victims in terms of three broad
categories: those whose injuries are so severe that they will perish in any
case, no matter what is done; those whose injuries are so minor that they
need no immediate attention; and those whose injuries are such that they
will survive if prompt medical assistance is given. In such a circumstance
the ethically responsible course of action for the physician would be to
devote his attention and resources to the third category of victims, i.e.,
those whose prospects for survival depend upon medical intervention. In a
situation where not all can be saved, the best course of action is to help
those who can be saved by means of the resources and opportunities at one's
disposal.
The application of the triage model to, say, a tubal
pregnancy should be evident. If no action is taken, and the tubal pregnancy
is allowed to progress, there is a genuine possibility that both mother and
child would perish as a result of bleeding from a ruptured Fallopian tube.
Given the existing capabilities of medical technology, and lacking an artificial
womb, there is no possibility of saving the embryonic human life developing
in the Fallopian tube. Surgical removal of the embryonic human being, in
order to save life having a prospect of survival (the mother's), is analogous
to the action of the physician at the train wreck who physically moves aside
a victim in a hopeless situation in order to treat the victim with some prospect
of survival. Given the further progress of medical technology and the development
of an artificial womb at some future time, it would then be possible to save
both mother and child, and the tragic dilemma would cease to arise. At present,
however, the choice is between saving one life or saving none.
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Life and Breath in Old Testament Thought
It has been pointed out that there is a significant connection
in Old Testament thought between life and breath (ruach; neshamah). This
connection may be observed in texts such as Genesis 6:17, Job 34:14-15, Habakkuk
2:19, Zechariah 12:1, Psalm 104:29-30, and Job 33:4. Could this relationship
determine whether personhood or human life is present in the womb? Could
one argue, for example, that since premature children of less than twenty
weeks' gestation are incapable of independent breathing outside the
womb, human life in the biblical sense is not present? Such an argument
might be offered to support abortion on demand in the first trimester of
pregnancy, and even into the second trimester.
There are a number of problems with this line of argument. First,
while breathing in the usual sense does not begin until birth, the process
of respiration in the more technical biological sense of the transfer
of oxygen from the environment of the living organism occurs from the time
of conception. The mode but not the fact of this oxygen
transfer changes at birth. The "breath of life" in this more general sense
is present from the beginning of prenatal life.
Second, it seems hermeneutically illegitimate to use texts (Ps.
104:29-30, etc.) concerned with ordinary, nonscientific observations
of postnatal life in relation to the scientific details of
its physiological development. The intention of these texts was not to describe
the physiological details of prenatal development or to provide the basis
of value judgments about prenatal life. The ancient Hebrews had only the
most rudimentary knowledge of human physiology. They knew little or nothing
of the respiratory system; the word for "lung" does not even occur in the
Old Testament. There are no distinctive Hebrew terms for brain, nerves,
diaphragm, or blood vessels (C. Ryder Smith, The Bible Doctrine of Man;
H.W. Robinson, The Christian Doctrine of Man; A.R. Johnson, The
Vitality of the Individual in the Thought of Ancient Israel). These texts
were clearly not focused primarily on the physiology of prenatal life. On
the other hand, texts such as Psalm 139:13-16 and Jeremiah 1:5 clearly do
intend to address the reality of God's concern for and involvement
with prenatal
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human life. Hermeneutically, it is these texts, rather than the "life
and breath" passages, that constitute the appropriate starting point for
reflection concerning the value of prenatal life in God's sight.
Third, a literalist and anachronistic reading of the "life and
breath" passages would logically require one to take literally biblical
statements concerning the bowels and kidneys as the seats of emotion and
the heart rather than the brain as the focal point of psychical activity.
If there is a connection between life and breath in Old Testament thought,
there is also a connection between life and blood (e.g., Gen. 9:4). A
literalistic hermeneutic in the latter case might lead one to conclude that
blood transfusions are prohibited by the Bible — a conclusion actually
drawn by Jehovah's Witnesses.
The above difficulties make it evident that the"life and breath"
passages of the Old Testament do not support a permissive policy on abortion
when taken in their proper context.