Science in Christian Perspective

Society and Abortion
HAROLD M. SPINKA
Practicing Physician
6132 So. Kedxie Ave.
Chicago, Illinois 60629

From: JASA 30 (March 1978): 13-15.

Introduction

Thirty years ago when I started out in general medical practice (I am now a specialist of skin diseases), therapeutic abortions were permitted if the mother was in danger, with the support of two specialists' consultation reports. Other abortions were outside the law and were done under questionable circumstances in most eases.

Today, here and abroad, society is taking action to implement the U.S. Supreme Court ruling on abortion. Foreign governments are acting to use abortion as a method of population control because there is a shortage of food and housing. Oral contraceptives (the pill), a major alternative to abortion, causes clotting deaths in 3 of each 100,000 people; this is higher than the normal maternal death ratio.

Additional Indications for Abortion

A sober reasoned understanding by society as a whole and by legislators in particular, is being obscured by extremist emotionalism, propaganda groups, and slogans, e.g., from "Right to Life," (no abortions), to "Abortion on Demand," (abortion without restrictions by society).¹

The following additional indications for the use of abortion may be cited.
1. In both defensive and offensive wars, in criminal justice and death sentences, and in large hospitals where there are not enough respirators or kidney dialysis machines to meet the demand, society must make the difficult choices of who shall live and who shall die. Therefore, abortion also is to be controlled by society.

2. In our public health programs, we must also include concern for the insane and the imbecile, sterilizations, adoption of orphans, prevention and conservation of resources, e.g., food, special housing, hospitals, medicines, etc., as well as concern for tax dollars. In ancient times, the Romans and Greeks would either slaughter the unwanted women, children, slaves, and aged, or leave them to die from exposure to the elements and animals.

3. For many people, suffering is a shattering and undermining experience; for them pain and suffering do not strengthen but rather weaken the moral fiber. We are not "super-man." This is contrary to the views of some of today's Christian clergymen.² Most of us do not need to be broken, tempted, and tortured in order to discover the goodness and love of God.

4. The defective child has become a heavy burden, both mentally and physically today, for both the family and society. Thoughtless neighbors by word and deed, imply that there is insanity in any family with a defective child, resulting in psychological damage to the other children in the home as well as the families involved. In addition to the heavy financial drain on the family's resources, the acquittal of the Belgian mother who killed her thalidomide deformed son, may encourage others in similar circumstances to follow her example. These and other situations have resulted in the recommendation of abortion if there is a psychological fear on the part of the mother.

5. Former Attorney-General Edward Levi (now Professor of Constitutional Law, University of Chicago Law School) states that

Law has some unique and special functions: it is not primarily a social science describing how some institutions operate; it is not primarily a tool for determining how transactions will turn out, or for predicting what courts will do; these are important services, but they are subsidiary to law's major commitment: to develop concepts, to maintain and operate procedures which enable a sovereign community to be governed by rule for the common good, the attainment of human values, and to make that rule effective.

Today, the legal profession also wishes to know the human rights, including the right of inheritance, of the fetus killed in an automobile accident.

6. The medical profession has made important advances and we present these to society for their assistance and to the legislators for guidance in framing laws to cover the following medical situations,

- We have a group of diseases, e.g., specific heart diseases, the rare Lupus Erythematosus, where the additional burden of a pregnancy will kill the mother unless it is terminated. This is under review at the present time,
- We know that if a woman acquires German Measles during the second trimester of pregnancy, i.e., 4-6 months, the fetus will be born dead, or have Congenital Rubella Syndrome, and this includes mental retardation.
- If a pregnant woman acquires one of the so-called "cyto-megalie virus diseases," the fetus is usually born with cataracts, a small head, an enlarged spleen, and mental retardation.
- We are aware and warn pregnant women, that death of the fetus can occur if she acquires Influenza, Measles, Mumps, or Chicken pox.
- With the recently developed amniocentesis procedure (withdrawing about 1 teaspoon of amniotic fluid found in the protective sac around the fetus for analysis), we are better able to identify defects due to heredity, such as:' (1) A pregnant woman over 3540 years of age with a previous child with a chromosomal disease is likely to have a child with Down's syndrome (this was formerly known by the cruel name of mongolism); (2) we are better able to evaluate parents who are carriers of inborn defects; (3) we are able to study and search for errors of metabolism if they are no a genetic basis; and (4) we are able in our family studies to find the so-called "chromosomal translocations,"
- The most common single genetic defects found today in the U.S.A. are (1) cystic fibrosis in the general Caucasian population, (2) sickle cell anemia in the black Americans, (3) Tay-Sachs syndrome in the Ashkenazi je'vs (European), (4) and thalassemia in the Mediterranean and oriental peoples.
- Today we are able to detect the carriers of 50 inborn errors of metabolism, and relay this information to the patients and their families.
- With the recently developed "Chromosomal Beading Teehnique,"a we are able to locate cases with structural rearrangement, to make a pre-natal diagnosis of male and female, and can now save many normal fetuses that were formerly sacrificed. Statistical risks that a fetus would be born with a particular disease, e.g., 1 in 4, or 1 in 500, are dispensed with. For example, if 1 in 400 black Americans would be born with sickle cell anemia, there would he a sacrifice of 399 normal fetuses, in addition to the affected one. Today, with amniocentesis and chromosomal beading, we are able to identify the affected fetus and allow the other 399 uninvolved fetuses to mature to full term.

Governments and Abortion Laws

A survey of history shows that laws of various types of governments relative to abortion were only partially effective guides and deterrents.
- In ancient times, both the Greek and Roman societies widely practiced abortion.
- In Greek society, if a disfigured woman (with child) was not pleasing to the eye of the man, abortion was allowed.
- In Roman society, the father had absolute power over the family. The fetus was a part of the mother and it was not wrong to kill the fetus.
- In the 11th century, the Longobard Edict demanded a fine only if the abortion was done without the consent of the mother or guardian.
- In the Bishopric of Bamberg (1507 AD), it was criminal abortion and murder only if the fetus was animate or viable.
- By 1800 AD, most German states dated animation of the fetus at 4.5 months.³

"When Does the Soul Enter the Body?"

This question has been under speculation for at least 3400 years, beginning with Akhnaton (1400 BC), for there are philosophical, religious and legal connotations.³ The following are only a few of the different points of view.
- To the Romans, animation was at 40 days, whereas the Stoics (around 300 BC) held that the soul entered the fetus just before birth.
- Plato (6th century BC) held that it was at birth, while the Hellenists (after 323 BC) stated that human status was acquired only after taking human food.
- The Christian community has a long and varied history. Instead of taking either the Stoic or Platonic view, they adopted Pythagorus' (6th cent. BC) view that the soul enters the body at the time of conception. This was also held by the others of the Hellenistic school of Greek thought, e.g. Peripatetis, Neoplatonists, Neo-pythagoreans, etc. Tertullian (2nd century AD Early Church Father) adopted the Pythagorean opinion, and this was approved by the church councils at Elvira (305 AD) and Angora (314 AD). These views were accepted by St. Jerome (5th century AD) and St. Augustine (5th century AD) held that to kill a formed fetus 40 days or older is homicide. The Justinian Code (6th century AD) exempted the first 40 days of life from the penalty of abortion, and this held true, except for a brief period (1589-1591 AD), until 1869 AD. The turning point was the Bull of Pope Sextus V (1588 AD) who held that the soul entered the fetus at conception. In 1869, Pope Pius IX dropped the 40 day rule, and this was re-confirmed in the current Canon Law Code of 1918. This is still in force today.2
- A review of Judaism shows that our Jewish friends are opposed to abortion, based on Deut. 30:15, "choose life," as their guiding principle, but based on Gen. 1:29, "be fruitful and multiply," state that each has the duty to have at least one son and one daughter. If they are barren for 10 years, they are eligible to apply for a divorce in the Jewish courts and to remarry in order to fulfill this duty. They applied the principle of compassion (i.e., responsiveness to the suffering of other human beings), to share suffering and so lessen and alleviate it, based on Jer. 8:21, "to be hurt ... for the hurt of My people": (1) marriage licenses are denied lepers, and since the time of Rashi (1040 AD), "any hereditary disease" was included; (2) rape is illegally sown seed, and is to be terminated; (3) in the presence of physical suffering or disease, abortion is permissible; (4) shame is the greatest of all pains, and the pain of the mother, actual or imagined, takes precedence over the fetus, permitting abortion.
Finally, our Jewish friends have developed a classification of four distinct legal phases for the fetus for their guidance : (1) stage 1 is from conception to the first stage of labor. The fetus has potential life just as the ovum has potential for fertilization, and is an organic part of the mother. If the life of the mother is threatened, one may remove the fetus, (2) Stage 2 is from the onset of labor through its various stages and up to the point that the head is emerging. The fetus has some human rights, but the mother still has priority over the fetus. (3) Stage 3 starts when the child is born and now has human status in most aspects. The mother is still saved at the expense of the child, and the child is a "stillborn" if the child does not live at least 30 days. (4) Stage 4 begins after 30 days of life, when the child has actual life, all the human rights, and status equal to the mother and father.⁴

The Recent U.S. Supreme Court Rulings

In the recent compromise decisions of the U.S. Supreme Court on abortions, they said in effect that (1) in the first trimester (1-3 months of fetal life) of the pregnancy, the pregnant woman and her physician have the total discretion over doing abortions; (2) in the third trimester (79 months of fetal life) when the fetus is viable, the state is authorized to prescribe abortions only on an emergency basis; (3) during the middle trimester (4-6 months of pregnancy), neither the state, the patient, nor the physician have total authority. Regulations for the safety of the pregnant woman can be established and enforced.⁷

Application of the U.S. Supreme Court Ruling

Society, the legal and the medical professions cannot find fault with these decisions for the guidance of the

We should be grateful and thankful for the additional guidance and direction provided for us in this complex problem by the U.S. Supreme Court.

community, although they may conflict with some religious beliefs. This compromise is apparently the best possible for all concerned at this time. This ruling does put limits on the individual and is a positive force in the training and guidance of both society and the individual.

As servants of society, the scientist, philosopher, priest, lawyer, physician and educator are to increase the general welfare for the betterment of society, through justice and the law, not by fiat from some self appointed prophet, but rather through education, truth, law, justice, righteousness, holiness, peace and order. We are a community of laws and not men; therefore we are to work for and through society at the slow but steady progress of mankind using the democratic principle, and not by one man rule, whether it is a F¸hrer, an Il Duce, or a commissar.

Our teachings are to be explained to society as a whole, and when a majority of the people are convinced that there is no harm and only good in our advice, our respective legislators will pass the appropriate laws, for one and all. This is the democratic and biblical way, based on Numbers 15:16, "One law and one ordinance shall be for you and the stranger (the permanent non-Jewish resident or immigrant) that sojourns with you."

It is in this setting that individual states have passed or rejected laws governing abortion for their respective communities. Today, we should be grateful and thankful for the additional guidance and direction provided for us in this complex religious, ethical, moral, philosophical, legal, and medical problem by the U.S. Supreme court.

REFERENCES

¹"Puljlic Health Groups Urge Liberal Abortion in Israel," Medical Tribune, Vol. 16, No. 5, Feb. 5, 1975, p. 29.
²Ramm, "The Ethical Evaluation of Bio-genetic Engineering," Journal ASA. Vol. 26, No. 4, Dec. 1974, pp. 137
143.
³D. M. Feldman, Marital Relations, Birth Control, and Abortion in Jewish Law, Schoeken Publishers, New York City, Paperback ed. 1974, 1968, New York University Press, New York City.
⁴Dr. Immanuel Jakobovits, Jewish Medical Ethics, Philosophical Library, New York City, 1959, pp. 153.191.
⁵H. Nora and F. C. Fraser, Medical Genetics, Principles and Practice, Lea and Febiger, 1974, Philadelphia.
⁶Pauk, Handbook of Christian Theology, Meridan Books, New York City, 1958, pp. 299-310.
⁷H. Mills, M.D., "Abortion," Journ, Am. Medical Assoc. Vol. 229, No. 3, July 15, 1974, p. 338.