The Planned Parenthood Video Doesn’t Matter

by Benjamin Studebaker

A new anti-abortion video has been doing the rounds. The video accuses US healthcare provider Planned Parenthood of profiting from the sale of tissue from aborted fetuses:

Planned Parenthood issued a video response in which it denied profiting from the sale of tissues and pointed out that the tissues are used for medical research:

Factcheck.org investigated and determined that the video is quite misleading–sections were edited out that indicate that the money PP receives merely helps to offset the costs of collecting, storing, and managing the tissues. Other researchers corroborated that account, pointing out that clinics generally take a loss. The law prohibiting the sale of tissues explicitly contains exemptions for these cost offsetting practices, and they are commonplace in medical research.

None of this likely to assuage abortion opponents because their objection has little to do with whether or not a profit has been made and everything to do with persuading the public that the use of fetal tissue for medical research is in and of itself morally disgusting. It’s for this reason that they opposed embryonic stem cell research regardless of its profitability for clinics. Their argument should not be persuasive. Here’s why.

Generally, the basic argument against abortion takes the following form:

  1. Fetuses are living humans.
  2. All human lives matter.
  3. Therefore, all fetuses matter.

If you buy into this argument, the idea that someone would crush or dismember a fetus and then use the parts for research will viscerally disgust you. But if you buy into this argument, you are already an opponent of abortion. The people the anti-abortion movement is trying to persuade are the people who do not buy into this argument. These people disagree with the fundamental argument underlying the claim that fetuses matter. They disagree in one of two ways:

  1. Some believe that fetuses are not living humans.
  2. Some believe that not all human lives matter equally.

Objection #1 is weak. On a biological level, fetuses are human, and many people who oppose abortion think that many non-human creatures can have moral worth (e.g. animals or aliens). The strength of the abortion argument comes not from the claim that fetuses are not humans but that some humans have no value or less value than others.

Most secular moral theorists believe that, at minimum, a being must be capable of suffering to have moral value.  The science on when fetuses begin to feel pain is disputed–some researchers believe that pain can be felt at 20 weeks, but many put it closer to 30. The implication is that before this pain threshold, a fetus has no intrinsic moral value at all. It can only have value instrumentally–to its parents or to its society. If society has no pressing need for additional people and the parents don’t want it, there is no compelling reason to preserve the life of a being that cannot experience pain and has no self-conception. So on most secular moral theories, there is nothing controversial about aborting a fetus at 20 weeks, and depending on which research we find most compelling the same may also be true for a fetus at 30 weeks. There would be nothing morally significant about using the parts of a being that has no moral value for research. This would be morally no different from conducting research on rocks.

To persuade people to fully ban abortion, the anti-abortion movement would have to persuade people that fetuses that lack the capacity to experience suffering have moral value. I see no obvious means by which they could do that, unless they converted these people to some religious doctrine that holds that fetuses are sacred because they are biologically human, created by a deity, etc. Most secular moral theorists are unlikely to buy into this.

The abortion argument gets more interesting once we start talking about fetuses that are beyond the pain threshold. Many moral theorists nonetheless believe that it is permissible to abort a fetus even after this point. There are two reasons they can give for this:

  1. It may be possible to kill the fetus without causing it pain.
  2. It is sometimes permissible to kill beings even when these beings will feel pain (e.g. for meat, in self-defense, etc.)

A being that experiences pain but is not capable of self-consciousness, of understanding itself as a continuing being and desiring further life, cannot be harmed if it is killed painlessly. In this way we can draw a further distinction between third trimester fetuses and adults–adults are self-conscious, they not only live but they want to continue to live and see their lives as long-term projects. Adults experience the prospect of death as a harm regardless of whether or not this death is painful. Fetuses are not capable of understanding themselves in this way. If you force a mother to keep an unwanted fetus, you thwart the mother’s long-term life project. But if you abort the fetus, the fetus does not experience a corresponding loss. In this way it is often argued that the mother’s interests take priority over the interests of even third trimester fetuses.

The issue with this argument is that it is not just fetuses that are incapable of self-conceptualizing in this sophisticated way. Infants cannot do this either and even small children can fail to fully comprehend or fear ceasing to exist. Infants and small children may comprehend and fear pain long before they come to conceive of their lives as long-term projects or extend that fear to non-existence or death as an abstract concept. So this argument would seem to imply that it is permissible not just to abort third trimester fetuses, but also infants and maybe even small children. Most people are not prepared to accept this conclusion, and yet it does seem evident that it is a much worse thing to take the life of a being with a self-conception than it is to take the life of a being without one. Few would deny that it is worse to kill an adult than it is a dog. A dog is roughly as intellectually capable as a 2 year old child. If instead of making babies, sexual activity caused dogs to randomly appear on the streets, this would not deter us from periodically reducing the dog population even though dogs are significantly more capable than newborns. We fill up animal shelters with stray dogs and put them down when the shelters are too full–we do not expect the state to take more stray dogs into care or expect people to adopt all the stray dogs. All of this suggests that we do think it is permissible to prioritize the welfare of adults over the welfare of beings with similar capacities to infants and small children, even when this priority entails killing the lower capacity being.

To avoid having to raise the issue of infanticide, a different argument is often substituted. This argument holds that women ought to have an inviolable right to bodily autonomy. This produces a clean break at birth, because once it is born an infant’s existence cannot infringe on the mother’s autonomy. But this raises issues that are arguably even more intractable than the issues raised by the self-concept argument. Our society routinely compels people to do things with their bodies for the public good. For instance, in a war we will often conscript individuals into the armed services, forcing them to place themselves in harm’s way for the benefit of everyone else. The chance of dying in a war is much higher than the chance of dying in pregnancy. If we acknowledge a full right to bodily autonomy, we would not be permitted to conscript people to fight in wars. There are some situations where it is clearly right to conscript people to fight in wars because otherwise large portions of the population will be killed or enslaved. So it follows that if we can sometimes compel people to fight in war, we could also sometimes compel them to carry out a pregnancy, if we had sufficiently compelling social reasons for doing so. Because this argument does not deny that the third trimester fetus has moral value, it cannot deny that preserving this value might constitute a social reason of sufficient strength to permit the state to compel women to carry pregnancies to term.

In practice, we might find that we almost never have social reasons of sufficient strength to permit the state to compel women to carry pregnancies to term. Our societies are not generally desperately underpopulated, so the state has little reason to insist that new people get created. But does our belief that we do not have social reasons of sufficient strength rest on an unacknowledged assumption that beings that do not have a sufficiently robust self-conception are less valuable than those that do? Could we compel a woman to endure the feelings that go along with a 9 month pregnancy if this were the only way to save the life of an adult? If one adult would not be sufficient, how many would it take? What if a woman could save a hundred adults? A thousand? A million? At some point, there would be a sufficient figure. When it comes to fetuses, there is usually no sufficient figure, because unless there are exceptional social circumstances (e.g. deep underpopulation such that the survival of our civilization is at stake) no number of third trimester fetuses together have the moral value of one adult woman. And yet if we were talking about infants instead of fetuses, many people would think that the infants are at least as valuable as the adults if not more valuable.

That doesn’t make any sense. Our positions are in conflict. We think that adults matter more than fetuses because of their capacities, but we think that small children matter as much or more than adults despite their capacities. Some propose that what really matters is potential, but this solves nothing–both fetuses and small children have a similar amount of potential. We seem forced to concede that either our intuitions or our beliefs are wrong. There seem to be three ways to go:

  1. Third trimester fetuses, infants, and small children are all of no substantive value.
  2. Third trimester fetuses, infants, and small children are all of highly significant value.
  3. Our focus on capacity is a mistake–there is some further feature that shows why we should care more about infants than fetuses.

I think #3 is right. The further feature is reciprocity–irrespective of the level of self-conception, a being is valuable insofar as that being is willing or capable of reciprocity, i.e. contributing something of moral value to other beings already regarded as morally valuable.

A fetus can be aborted because a fetus can only reciprocate if it is wanted. A fetus’ value comes from the fact that its parents want it. If the parents do not want it, the fetus only has value if society has some compelling reason to want it. Given that society has not yet invested anything in the long-term welfare of the fetus and society is not dramatically underpopulated, society generally has no reasons to want unwanted fetuses. Indeed, society has reasons to want unwanted fetuses to be aborted–an unwanted fetus is more likely to be parented poorly and to consequently become inadequately socialized. This makes it more likely to become a future burden to the state.

By contrast, an infant already represents a significant investment by the community. Pregnant mothers often take off work before or after the birth, and a great deal of medical resources are committed to ensure the birth goes well. The infant is given citizenship, and with this act the state takes responsibility for the welfare of the infant, committing to show that infant equal moral and political concern. The state is both invested in the infant and committed by the contract of citizenship to show concern. If the infant is killed at this point, its rights as a citizen are violated and the state’s efforts are negated. The older a child gets, the more invested the state becomes and the worse it is to kill the child. If an infant or child is being abused, the state takes the infant or child into care because infants and children are citizens with substantive reciprocal moral value.

So I would argue that it is the act of granting citizenship that gives a new person moral standing. It is for this same reason that governments are permitted to place a much higher priority on the welfare of their own citizens than on the welfare of non-citizens. Any conception of moral value that relies exclusively on the ability of the being to suffer or on the being’s self-conception would necessarily have to maintain that there is no moral difference in value between citizens and non-citizens. It would compel wealthy states to give away huge portions of their wealth to poorer states. To the extent that this sounds plausible, it is only plausible because many of us believe that the wealthy states are to blame for the poverty in the poorer states. If we discovered a new desperately poor civilization on Mars with a population of 10 billion, this would not create a moral imperative for us to give the 10 billion poor Martians most of our wealth.

Citizenship should be extended to any being that is willing and capable of reciprocity, regardless of place of birth, age, race, sex, ethnicity, species, etc. Reciprocity should be understood to be either hard (i.e. discrete economic benefits) or soft (i.e. less concrete psychological benefits). Both hard and soft reciprocity should be taken seriously as forms of reciprocity. Infants and children are not yet capable of much in the way of hard reciprocity, but they are excellent soft reciprocators. Fetuses do not yet reciprocate in any way. For this reason we should immediately give citizenship to healthy infants and protect them from harm, but it remains permissible to abort fetuses, even in the third trimester, if they are unwanted by their own parents.