Abstract
This book addresses the political and legal situation of abortion in the United States in considerable detail. While discussing some of the main evidence and arguments with regard to abortion, Camosy attempts to develop a consistent moral and legal approach to abortion which he considers to be both realistic, in the light of public opinion trends, and in line with Catholic teaching.
Camosy points out that many women are pressured to have abortions by individuals such as boyfriends, parents, and bosses, as well as social structures of most of the developed world. He asks, what have women gained from the choice to have abortions? In reality, such a “choice” has actually made it more difficult for women to choose to have children, and has resulted in more STDs and less committed male partners. To those who argue that people with strong religious views should not have a voice in the public domain, Camosy astutely points out that everyone, including utilitarians and humanists, bring faith claims to the table.
Referring to a number of studies, Camosy observes that abortion is hardly rare in the US—roughly one-third of women will have an abortion during their reproductive years. Ninety percent of prenatal children diagnosed with Down syndrome are aborted despite people with Down syndrome being happier than “normal” people. In the last twenty years in the US, there has been a dramatic shift towards more legal restrictions on abortion. Young people are trending to be more pro-life. More women than men oppose legalized abortion. He calls “pro-lifers” in public debate to focus on the overwhelming number of abortions which most of the public do not support, rather than on the small minority of abortions (related to rape, about 1 percent, and the life of the mother, about 1 percent) for which the majority supports choice.
Camosy argues that biological science has made it clear that the human fetus is an individual organism of the human species. He affirms that both human infants and prenatal human children are persons, because they are “beings with the natural potential for … the capacity to know and the capacity to love” (56, original emphasis). They have a nature and potential that no other animal on earth has, and they deserve equal protection of the law with other human persons.
The Catholic Church considers direct abortion to be always wrong, but indirect abortion can be moral for proportionate reasons, for example, removing the cancerous uterus of a pregnant woman to save her life. Camosy expands on this stating that a police officer can defend the innocent against an insane shooter. Here Camosy considers the insane shooter “formally” innocent, but “materially” a mortal threat (67). He agrees with Popes Pius XI and John Paul II that the prenatal child should not be considered an “unjust aggressor.” Nevertheless, Camosy argues that the prenatal child could be a material mortal threat to the mother in certain extreme cases. Although the mother could choose martyrdom, defending the mother's life could be comparable to using mortal force to stop the insane shooter—these must be carried out only as a last resort. Regarding such abortions, Camosy uses the example of pulmonary hypertension, noting such cases would be extremely rare. He says we should work to discover techniques that would not require aiming at the death of the prenatal child in such cases. Camosy notes that the Congregation for the Doctrine of the Faith has encouraged moral theologians to debate the life-of-the-mother exception. Related to his own proposals, he urges “Catholics to form their consciences in light of the church's position [if it defined a position contrary to his own] rather than the one I offer here” (181).
With regard to refusing to aid for proportionate reasons, Camosy describes an actual case where the parents agreed to induce labor after viability of a child with Potter syndrome, so as to hold and baptize the child. If this had not been done, the child would most likely have lived longer. It probably would have died before being born, although it may also have lived until shortly after natural birth. As a Catholic moral theologian, it seems to me that it would have been better to have allowed this child to die of natural causes, rather than act in a way that resulted in the child dying sooner for these reasons. Was this really in the child's best interests? Surely, God would not deprive a child of salvation, who did not receive baptism, because her parents allowed nature to take its course.
A man's choice to have sex brings with it the natural obligation to aid any children that might result. Camosy affirms that natural duties to our children require very high levels of sacrifice. He says the situation is different if a woman became pregnant by raping a man with a drug—he would then not be required to pay child support. A woman pregnant as a result of rape has also not freely acted in a way that may lead to her becoming a parent. Related to this, Camosy suggests that a woman pregnant as a result of rape may be able morally to refuse to provide aid for proportionate reasons by inducing premature delivery or by taking RU-486. He does not consider RU-486 to be a direct abortion method because it works by cutting “off the pregnancy hormone (progesterone), which then detaches the fetus from the uterus and flushes it from the woman's body by inducing a period” (82).
In my view, however, this is faulty reasoning. By way of comparison, for example, one can kill someone not only by doing serious direct damage to their body, but also by starving them or depriving them of oxygen. With regard to refusing to aid for proportionate reasons, it seems to me that there is a significant difference between not supporting life by disproportionate medical means, which Catholic teaching allows, and not continuing to support life by natural means such as a pregnant woman supporting her child growing within her—in a sense she does not even need to do anything. She simply allows the child to grow and develop in its natural environment within her. I think it is objectively immoral for her to end the pregnancy by a means such as RU-486 knowing that the child will die. When the child is born she may give it up for adoption if she finds raising the child very difficult. In the case of a woman pregnant as a result of rape, however, there may certainly be subjective factors that could mitigate her culpability if she chose to have an abortion. Related to refusing to aid, Camosy raises some good comparison questions about whether or not we have a moral obligation to spend our vacation money to save people from dying.
Camosy takes up the challenge of public policy in the book's fourth chapter. Responding to a criticism of Paul Simmons that we should not impose “an abstract metaphysical point of view” that circumvents the democratic process, Camosy points out that this is what the US Supreme Court did in Roe and Casey (88–89). Because of improved medical technology, Camosy argues that “it is unlikely that the maternal death rate from abortions would rise significantly if most abortions were made illegal” (98). The European Court of Human Rights in 2010 upheld Ireland's restrictive abortion law saying that there is “no fundamental legal right to abortion” (99–100). Ireland has a very low abortion rate, but also a lower maternal death rate than the United States. Poland which prohibits abortion in all cases except when the mother's life is threatened or in cases of rape also is a safer place for pregnant women than the United States and the United Kingdom (100–1). Camosy thus shows that some positions which are accepted as “true” by many do not have good empirical support (e.g., putting serious restrictions on access to abortion does not in general endanger women's health). While punishment should be proportionate to the seriousness of the crime, Camosy agrees with many pro-lifers that women are the second victims of abortion. They should be shown mercy, whereas abortion providers are not subject to the same pressures as are many women.
In discussing women and abortion (Ch. 5), Camosy emphasizes looking at the facts and arguments, rather than ad hominem attacks, or trying to disqualify someone's views because they do not have certain experience, such as a man not having experienced pregnancy. As a comparison he says that one does not need to be running a business to be able to offer a view about just wages. Of women who seek an abortion and are denied for various reasons, “only 5 percent later end up regretting not getting the abortion” (112). Camosy explains in some detail Sydney Callahan's criticism of pro-choice feminism, as not really for women, and her intellectual support for pro-life feminism, which makes room for the biological reality of women. To offer women genuine reproductive freedom would require social structures that honor their differences from men. Women who had an abortion were 81 percent more likely to have mental health problems. Concerning women, Camosy advocates a number of changes in the US to improve maternity leave and early child support to really support women in having and raising children rather than many feeling “pressured” to have an abortion for economic reasons. Some of these changes would make the US more in line with what already exists in some other countries. They would make women in reality more equal with men economically, considering real differences such as that only women can get pregnant. He relates these to Catholic social teaching including having a preferential option for the poor.
Camosy develops his own proposal which he calls the Mother and Prenatal Child Protection Act (MPCPA). He argues that it would be legally and politically viable in the US, being consistent with the direction of the legal interpretation of the Constitution by the Supreme Court and with public opinion. In his view the Supreme Court in the Casey case has almost overturned Roe, by allowing states to regulate abortion in defense of fetal life, as long as these regulations do not unduly burden women seeking abortion. Many different kinds of social programs in the US have already changed the burden on pregnant women, but more needs to be done. The law should give the same protection to all members of our species including prenatal children—no one can legally aim at their death except in self-defense or in defense of another. His proposal refuses to prioritize either mother or prenatal child over the other.
Camosy outlines a number of necessary steps to support women to be both mothers and to be full participants in our broader culture. These include: equal pay for equal work regardless of gender, better paid parental leave, subsidized child care, removing the adoption stigma, making it a punishable crime to coerce a woman to have an abortion, and, if the pregnancy poses a deadly threat to a woman's life, giving the woman the right to self-defense as a last resort. He says such abortions would be extremely rare. His proposal would require an independent team of physicians and community members to confirm this. He says a fetus with serious malformations or disease should be treated as we should treat other disabled people. He thinks sex-selection abortions should also be hate crimes.
His proposal would legally allow the woman to refuse to aid her unborn child for a proportionately serious reason by induced labor in cases where there is a serious threat to the woman's life or health, or an unambiguous terminal diagnosis of the prenatal child with a significant chance that the baby would die in utero, or in cases of rape until the eighth week of pregnancy by RU-486. He proposes that physicians who perform an abortion procured to end the life of the fetus be charged with a Class A felony under the federal fetal homicide law and that indirect abortion be treated as a Class B felony except for the exceptions he has mentioned. Camosy also notes the importance of the law as a moral teacher, that is, if the law considers a behavior to be wrong or a crime this will influence the thinking of many. He thinks 55–60 percent of the American people would support the law he proposes based on public opinion polls.
Camosy addresses those who would likely oppose his proposal including hard-core pro-choicers who oppose any restrictions on abortions and hard-core pro-lifers who want to ban all abortions. He says Catholics should support his proposal “since 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” (157).
A central theme of Camosy's book is that confusion and polarization have created a false “illusion that the abortion debate is at a hopeless stalemate” (159, original emphasis). He urges Christian churches to have both a pro-life ministry and a ministry to aid pregnant women, needy mothers, and their children. We should avoid thinking of others with whom we strongly disagree as “enemies,” but treat them as worthy of respect and listen to them to understand, as well as attempt to persuade and convince. He highlights two moral principles which can help us move forward: (1) consistent non-violence, and (2) a preferential option for the vulnerable and marginalized. These can help us move beyond the false view “that we are forced to choose between protecting either the fetus or her mother” (166).
Camosy's approach is certainly in line with the saying “to love them both.” He tries to apply this consistently, both theoretically, in terms of principles, and practically, in terms of laws and governmental policies. While his book is academically rigorous, he cannot be accused of taking an “ivory tower” approach. He honestly considers the practical implications of applying principles, including to very difficult cases. Camosy is very well informed on many aspects of the abortion issue.
Some of the material in the book is repeated. This would be unnecessary for an attentive reader who reads the whole book within a short time. There may be some rationale for this, however, for those readers who just read (or later reread) parts of the book.
In this book Camosy tries to develop a consistent moral and legal approach to abortion in the light of both the prenatal child and the woman being persons of equal dignity. Not everyone will agree with all of his points. As a Catholic moral theologian, as explained above, I disagree with two of his moral proposals: his attempt to justify inducing labor before a terminal prenatal child is likely to die before birth, and his suggesting that a woman pregnant as a result of rape may not be required to support the child for proportionate reasons and that she may end the pregnancy with RU-486. Nevertheless, I think this book makes a very significant contribution to approaching abortion legally and politically. It points out some wide areas of agreement “beyond the abortion wars.” I think Camosy also raises some of the moral issues well. With the qualifications noted, I recommend it to a wide variety of readers including politicians, legal and healthcare professionals, ethicists, and educated members of the general public.