Shayla: May a woman whose life is threatened by the pregnancy abort?
Extended: A woman was involved in an accident that resulted in the removal of one third of her uterus. There is also substantial scarring that render a pregnancy dangerous. Her husband had a vasectomy so that a pregnancy that would threaten her life would not take place. Nevertheless, against all odds, the woman became pregnant. If she allows the pregnancy to continue, the child will not be able to properly mature in the reduced uterus and will die. If the pregnancy were to reach that point, the woman’s life would also be at risk. The doctors recommend she have a hysterectomy in order to save her life and to provide permanent safety from this ever happening again. However, a hysterectomy will result in the death of the child.
Responsum:
As clearly stated elsewhere,[1] the elders of our congregation are unapologetically opposed to abortion. We are opposed to aborting a rapist’s child.[2] We are even against abortion when the child will die upon being born as is the case of an anencephalic child.[3]
Four scenarios. In the past we have judged as following:
Woman safe + child safe = child should be born
Woman safe + child dies = child should be born
However, we have a different issue before us. In this case, if the pregnancy goes to term, both the mother and the child will very likely die. However, for the sake of clarity, we will use the opportunity to also explore another potential ethical dilemma. The two situations may be described in the following manner:
Woman dies + child safe
Woman dies + child dies[4]
In the last scenario, many would be comfortable even with an abortion because most people would agree that an abortion to save the mother’s life is morally justified since it is a greater good that one live (the mother) than that two die (the mother and the child).
However, just because it makes sense to sinful humans doesn’t necessarily make it the right thing to do. We hold to the absolute authority of Jesus the Messiah and His Word. Only if a concept can be clearly and rightly taught from the Scriptures do we accept it as devar mishnah (clear, black letter law).
So what do the Scriptures teach on this issue? It is unnecessary to revisit all the Scriptures regarding the status of the child. That has been amply argued elsewhere. Suffice it to say that we believe the child, from conception,
1. Is fully human,
2. Is fully a person,
3. Has a right to life,
4. Possesses a moral call on the parents for support of every kind until it can achieve personal autonomy.
Moral obligations are hierarchical. However, we also believe that justice is hierarchical and in that hierarchy life trumps other moral obligations. For instance, it is generally wrong to lie yet when Rahab lied to save the lives of the two spies, she not only did not incur judgment but was blessed precisely for her action.
· Her life and the lives of her family were saved. (Joshua 6:17)
·
She was given citizenship in Israel, the Chosen
People. (Joshua 6:25)
·
She became the grandmother of King David. (Matthew
1:5-6)
·
She was granted a place in the lineage of the
Messiah. (Matthew 1:16)
·
She was included in the great “Hall of Faith”.
(Hebrews 11:31)
·
We are told that her decision is actually what
justified her. (James 2:25)
Similarly, David deceived a Philistine king in order to protect his own
life.[5]
In another case, while running from Saul, David lied, not just to Lowlander
guards or a godless Philistine king, but to a priest of the Lord in order to
save the life of the priest.
·
1 Samuel 21:1-2 HCSB David went to Ahimelech the priest at Nob. Ahimelech
was afraid to meet David, so he said to him, "Why are
you alone and no one is with you?"
(2)
David answered Ahimelech the priest, "The
king gave me a mission, but he told me, 'Don't let anyone know anything about
the mission I'm sending you on or what I have ordered you to do.' I have
stationed my young men at a certain place.
Ahimelech obviously knew something was up since he
was afraid to meet with David. We also know that he knew of David’s desperate
plight because he was willing to give David the normally forbidden consecrated
bread. Yet David’s lie and Ahimilech’s complicity
with the weak deception, provided the priests and their families
plausible deniability and was designed to save their lives. Unfortunately the
strategy failed due to wicked Doeg, and to
demon-possessed Saul. However, the fact that David lied to a priest of the Lord
and ate the consecrated bread without condemnation from the Lord indicates that
life trumped even the elements of the Tabernacle!
Another noteworthy element of this story is the fact that Ahimelech armed David.
·
1 Samuel 21:8-9 HCSB David said to Ahimelech, "Do you have a spear or sword on hand? I
didn't even bring my sword or my weapons since the king's mission was
urgent." (9) The priest replied, "The sword of
Goliath the Philistine, whom you killed in the valley of Elah,
is here, wrapped in a cloth behind the ephod. If you want to take it for
yourself, then take it, for there isn't another one here." "There's
none like it!" David said. "Give it to me."
What was that sword for if not for combat? Obviously Ahimelech
believed that taking up a sword and killing others was allowed with the right
moral justification.
In yet another case Hashem’s judge Ehud lied to
king Eglon and assassinated him, delivering the
people of Israel from his oppressive rule.[6]
In that case the life of the many trumped the life of the individual.
We could go on but hopefully by now the reader gets the idea. So in this
hierarchy we have seen:
1.
Life trumps honesty.
2.
Life trumps consecrated Tabernacle elements.
3.
Life (wrongly threatened) trumps life (that wrongly
threatens).
4.
Life of many trumps the life of one.
By the way, the third and fourth points go hand in hand with our
teaching on the issue of capital punishment.
Woman dies + child
dies. Thus in the case of:
Woman dies + child dies
We believe that the hysterectomy should be permitted due to the
possibility of salvaging one life and the prevention of any future children
from being put at risk by the mother’s condition. This is enhanced by our
understanding that children who die before the age of accountability are not
blotted from the Book of Life and automatically go to heaven.[7]
Woman dies + child
safe. Then there is the last, most challenging case:
Woman dies + child safe
We believe that when speaking of abortion it is an error to speak of the
mother and the unborn child in adversarial terms (i.e
mother’s rights vs. the fetus’ rights). To us it is wrongheaded to think of
them as individuals who compete for independent existence. For Adonaists, the
relationship between mother and unborn child is a loving relationship, which by
our definition means a mutually serving, sacrificial relationship.
Mother is the
active agent. In each of the cases we’ve considered the woman was the active agent.
She could actively harm the child but the child could not actively end the
mother’s life. The child could not go to a doctor and have the mother aborted.
The child could not take up a coat hanger and rid itself of an unwanted mother.
The moral responsibility should be on the active agent. If anyone should
sacrifice themselves it should be the one who can deliberately choose that
path.
Other factors
should be considered too. However, there are a couple of other factors that
must be considered. First, the relative margins of safety should be carefully
considered. As the chances of the unborn child’s survival diminish, so too
should the moral pressure on the woman to sacrifice herself.
As the chances of the unborn child’s survival increase, so
too should the moral pressure on the woman to consider self-sacrifice increase.
Second, the woman and child may not be the only actors. If there are
other children who have been safely brought to term, her responsibility to
those children must carry substantial weight. The same argument can be used for
a situation I’ve encountered in third world countries. In Chad 209 of every thousand
children die before the age of one. So if the tribe must make a decision
between a woman and an unborn child, they choose the woman because the odds of
the child surviving are terrible, whereas the woman has safely passed that
threat and may conceive other children later. In that case it is the lives of
future children that must be weighed against the life of the at risk child.
Thus, in the case of “woman dies + child safe”, steps resulting in the
child’s death may be permitted depending on the circumstances. The woman may
choose to lay her life down for the sake of her child but that heroic action
may not be demanded of her just as we cannot demand heroic, “above the normal
call of duty”, action of individuals in other situations.
Doctrine of Double
Effect. Another way of looking at this is the Doctrine of Double Effect
(hereafter abbreviated DDE) developed by Thomas Aquinas. DDE is a set of
criteria that allow one to judge whether a given action is morally permissible.
For example, would a doctor be allowed to relieve a terminal patient’s pain (a
permissible act) when said relief would hasten the patient’s death (a generally
forbidden act)?
There are four conditions that must be considered:
The DDE also supports the decision to have the hysterectomy. If you
like, think of it this way. Consider a patient who is terminally ill. The
family may choose to not pursue heroic measures, instead allowing the natural
process to take the patient home. Though they did not take heroic measures to
save the patient, they did not kill the patient. The circumstance or medical
condition is what killed the patient. In our case there is a difficult
circumstance that unfortunately limits the child’s lifespan – the hysterectomy.
Summary. In summary, in
the case before us where both the woman’s and the child’s lives are threatened
with a high degree of certitude, we would agree that the hysterectomy must be
allowed even though it will necessarily limit the lifespan of the child.
Processing the
grief. We suggest the following. On the day the procedure will take place,
allow the elders to attend the mother, pray for her, ask for God’s grace and
mercy, and commit the child to His safekeeping with the understanding that we
will soon join the child in heaven. After the procedure, ensure that the family
is offered counseling for grief and loss.
We would also strongly recommend observing the custom of sitting shiva for the child. Shiva is a week-long period of
mourning for a close relative.
·
Genesis 50:10 HCSB When they reached the
threshing floor of Atad, which is across the Jordan,
they lamented and wept loudly, and Joseph mourned seven days for his father.
Rather than hurrying to “return to normal” and avoiding processing the
loss, sitting shiva allows the mourners to take one
week to fully focus on and process their grief. Another advantage of sitting shiva is that it demonstrates k’vod
ha-meit (respect for the dead). Lowlanders turn their
unborn children into objects; into obstacles to personal comfort or career in
order to minimize the guilt of killing them. In contrast, though the death of
the child may be necessary, we want to maintain our respect for the child’s
life and continue to acknowledge their humanity and their call on our lives for
grief at their loss. After all, a human died so that another could live. At the
very least the survivor can offer grateful respect.
[1] See Topical study: Abortion; and Counseling, dating FAQ; etc.
[2] See Responsum: “Must I carry my rapist’s child?”
[3] See Responsum “Should an anencephalic baby be aborted?”
[4] In each of the mentioned scenarios, coming to term is considered a constant.
[5] 1 Samuel 21:13
[6] Judges 3:13-29
[7] See topical study “Book of Life” and Meforshim “What is the age of accountability?”