Schrödinger’s Baby…

As spineless capitulations go the recent efforts of Cardinal Cormac Murphy-O’Connor to reignite the debate on abortion on the back the technical arguments about foetal viability is up there with the best of them, whether that be the pseudo-science of the so-called ‘intelligent design theory – which manages to be neither intelligent nor a scientific theory – and the late Pope John Paul’s acceptance of Big Bang Theory, but only so long as cosmologists steer clear of investigating the actual Big Bang itself – he actually admonished a group of physicists, including Stephen Hawking, to that effect, as Hawking notes in ‘A Brief History of Time’.

The position of the Catholic Church on abortion, as with numerous other religious groups, is the same as it ever was. They oppose abortion outright on moral/doctrinal grounds, which makes their adoption of lines of argument based on the advance of medical science fundamentally disingenuous as their real aim is not to seek an appropriate balance between the rights of women and those nominally ascribed to a gestating embryo/foetus but rather to manipulate the public perception of medical technology in an effort to subject current abortion laws to an regime that amounts to no more than ‘death by a thousand cuts’. Such an approach, which is still, typically, based more on unscientific appeals to emotion/perception than actual hard scientific evidence, is perhaps best characterised as ‘if you can’t beat ’em, subvert ’em’, which makes it all the more gratifying that despite his having secured an audience with Health Secretary, Patricia Hewitt, Murphy-O’Connor seems to have largely failed, as yet, to spark off the kind of wide-ranging public debate he was, no doubt, hoping for and where discussions have sprung up, their general tone has been something less than that which the Catholic Prelate might have hoped for.

Before going too much further I should point you in the general direction of a couple of discussions that are well worth checking out – if you read nothing else then take a look at this debate between Owen Barder and Rob of Consider Phlebas, which is certainly a cut above the usual standard one finds whenever this issue crops up. Tim Worstall (and comments) also offers up much food for thought as does this article from the archives of Dr Crippen, which should also be considered required reading – even if I do take the Bill Hicks view of the term ‘pro-life’…

You know who ís really bugging me these days. These pro-lifers …

You ever look at their faces? "I’m pro-life!"

"I’m pro-life!"… Boy, they look it don’t they? They just exude joie de vie. You just want to hang with them and play Trivial Pursuit all night long.

You know what bugs me about them? If you’re so pro-life, do me a favour – don’t lock arms and block medical clinics. If you’re so pro-life, lock arms and block cemeteries… Let’s see how committed you are to this idea.

(Bill mimes the pursed lipped pro-lifers locking arms.)

Bill: (as pro-lifer) She can’t come in!

Bill: (as confused member of funeral procession) She was 98. She was hit by a bus!

Bill: (as pro-lifer) There’s options!

Bill: (as confused member of funeral procession) What else can we do? Have her stuffed?

I want to see pro-lifers with crowbars at funerals opening caskets – "get out!" Then I’d be really impressed by their mission.

Finally, on the links front, Emily,  who blogs at Second Child Syndrome, offers up a personal perspective which should also be considered essential reading in a post that will also be getting a nomination for the next of Tim’s Britblog Reviews.

Having said that, my own interest, like Tim’s, has been piqued by Roy Hattersley’s column for the Guardian, which makes some very good points and yet, for all that, remains deeply flawed in one of its central arguments, on the question of how one might define precisely when an embryo/foetus acquires the right to life in its own distinct right, in which Hattersley makes the grievous, if understandable, error of concentrating on the question of viability to the exclusion of other considerations…

The rules that should govern an ethically acceptable policy on abortion are not difficult to define. Metaphysics aside, it is reasonable to conclude that the new human being begins when the foetus is capable of independent life. Before that, an abortion is undesirable but tolerable. After that, it is only acceptable in the most extreme cases. They do not include the psychological trauma of the expectant mother. A civilised society does not kill one person in order to alleviate the distress of another, no matter how traumatic it may be.

This idea, that the moral and ethical value of the embryo/foetus is bound up in its capacity to exist independently of it’s mother’s womb is seductive, even compelling, in its simplicity – which is precisely why it is wrong, maybe not quite so wrong as the argument that life, and therefore the notional rights of the embryo, begins at conception, but wrong nonetheless.

Part of the problem here lies in the mutability of the notion of independence, as Dr Crippen notes in the comment on Tim’s piece is his usual forthright manner:

Dear me, no.

Capable of independent life?

If that is the criterion for abortion, it would be acceptable until the child is about 4 years old.

Sorry to be pedantic, but you (or Hattersley) cannot slip that one through.

Even if one is not quite so deliberately literal in interpreting the phrase ‘capable of independent life’ and confines one’s view only to that point at which the foetus, as it would be at that stage, is capable of survival on the basis only of that care which the mother might reasonably provide then the boundaries of ‘independent life’ are still to be found at a very late stage in gestation, considerably later than the current 24-week legal limit on abortions other than where there is evidence of foetal abnormality.

What Hattersley is, in fact, doing here is defining the parameters of ‘independent life’ not in terms of the actual capacity of the foetus for independent life but in terms of the capacity of medical technology to sustain the life of the foetus outside the mother’s womb until such time as it becomes capable of independent life, which is altogether a very different thing as, by extension, what he is doing is ascribing moral value to the foetus on the basis of the present state of medical technology not on the inherent qualities of the foetus itself. Superficially this may appear to provide a rational and objective basis for making such a determination but, in truth, such decisions are entirely mechanistic and give no consideration to what must the central moral and ethical question that underpins this debate, that of when the foetus becomes sufficiently human in nature to acquire a notional set of rights distinct from those of its mother.

That one question is, for most people, the crux of the matter – when does life begin – or rather when does human life begin, as for all but the strictest adherents to certain religions (Jainism and some strands of Buddhism, in the main) and the most ardent supporters of animal rights, such a question simply does not arise in respect of other species.

To accept that life begins at the point of conception requires, first, that one accepts some notional concept of the existence of a soul or similar life-force whose existence cannot be verified in scientific terms – the starting point for this is therefore a matter of belief (or superstition, depending on your personal view of the nature of religion). Moreover, and in much more mundane terms, such a view ignores a simple and extremely inconvenient biological fact; a large proportion, if not the majority, of conceptions do not result in pregnancy; for various reasons, many not always apparent, fertilised eggs simply fail to implant in the womb and are, consequently, expelled from the body during the normal course of menstruation with the woman being none the wiser as to the fact that a conception occurred. The believer may attempt to rationalise this by the usual, some might say obligatory, appeal to ‘God’s Will’ but, logically, if one does believe that a notional soul is present from the point of conception then one must also except that god, in whatever form you believe such an entity (or entities) to exist, also has a hell of discard pile, a view which flies in the face of the orthodox position in monotheistic religions, although if one’s beliefs also encompass reincarnation you position is rather more secure as your deity at least has the option of recycling to cover such a scenario.

And as noted earlier, the humanist view, in which judgements are based on the notions of viability, fails to address the underlying moral/ethical questions as to the nature of humanity and where, in the biological process of life, such a concept become meaningful and, in effect, places a value of human life that is based on its own characteristics but, more or less, on the capabilities of medical science.

Neither view, therefore, really addresses, in any meaningful sense, the central question of what is human life and when does it actually begin – the answer to which, I would certainly contend, is the only genuinely meaningful basis upon which one can rationally begin to consider the wider moral and ethical questions raised by abortion.

– – –

I gave this piece the title ‘Schrödinger’s Baby’ because while thinking things through I stated to see parallels between some of the moral and ethical question posed by abortion and Erwin Schrödinger’s classic thought experiment, which is usually referred to as the ‘Schrödinger’s Cat’ experiment, in which the eponymous (and entirely hypothetical) cat is used an analogy to explore the paradoxical nature of quantum indeterminacy predicted by Heisenburg’s Uncertainty Principle.

The experiment, itself, is described as follows:

A cat is placed in a sealed box. Attached to the box is an apparatus containing a radioactive atomic nucleus and a canister of poison gas. This apparatus is separated from the cat in such a way that the cat can in no way interfere with it. The experiment is set up so that there is exactly a 50% chance of the nucleus decaying in one hour. If the nucleus decays, it will emit a particle that triggers the apparatus, which opens the canister and kills the cat. If the nucleus does not decay, then the cat remains alive. According to quantum mechanics, the unobserved nucleus is described as a superposition (meaning it exists partly as each simultaneously) of "decayed nucleus" and "undecayed nucleus". However, when the box is opened the experimenter sees only a "decayed nucleus/dead cat" or an "undecayed nucleus/living cat.

The question that Schrödinger posed was simply that of when does the system cease to be a mixture of states and become either one or the other, his intent being to illustrate the view that quantum mechanics, at the time, was incomplete as it lacked the rules necessary to relate the quantum description of events to those described in terms of classical physics.

The relevance of this to abortion lies in what has become the mainstream view of how the paradox set out by Schrödinger should be interpreted, which takes the view that the act of observation (i.e. opening the box to see if the cat is dead or alive) which serves to determine its state – while the box remains closed, the state of the cat is considered to be indeterminate.

To some extent, this also describes the historical status of the embryo/foetus, certainly up to the point in time where medical science began both to understand the process of foetal development and to develop the various tools necessary to monitor that development as it took place. The parallel has, of course, never been exact, in the sense from 15-18 weeks gestation right up to the point of birth a women can feel the foetus moving inside her and therefore has a means of measuring the ‘state’ of the foetus that does not rely on the equivalent of actually opening the box – i.e. birth and has become less exact as medical technology, such as ultrasound scanning, has developed.

What we have, therefore, is an analogy based on variation of a theme by Schrödinger, one in which the cat is still in the box, except that now the lid is made of semi-transparent perspex, but the box is also subject to a time-switch which prevents it being opened until a fixed point in time, one which is randomly set within a range around a median point (analogous to the full gestation period of forty week in pregnancy) with which the observer cannot tamper would there being some measurable risk that trying to open the box at any time up to and including the time at which the box is due to open might trigger the poison gas and kill the cat before it can be safely removed from the box.

The question posed by this variation is also slightly different from that proposed by Schrödinger in the sense that what we are concern with, primarily, is not the state of the cat at a defined point in time, buts it likely state at the conclusion of the experiment – knowing that there is a 50% chance that the trigger particle will decay and release the poison gas at any given time can we make any definite prediction as to the state of the cat at the conclusion of the experiment based on an observation of its state and a particular point in time?

In fact, if one thinks logically, we can – but only if the poison gas has been triggered and the cat is dead. If however, the cat is still alive at the point the observation is made, the best we can say given that there is a fixed probability of particle decay of 50% at any given moment is that the cat as a 50% chance of still being alive at the conclusion of the experiment – the cat’s state at a particular time may be determined by observation but its state at the conclusion of the experiment remains indeterminate right to the very end.

What I am trying to illustrate here is one of the more complex moral and ethical conundrums of abortion, that of seeking to balance the rights of the pregnant women with those accorded to the foetus.

Unless one takes an absolutist view that holds that the rights of the woman remain pre-eminent throughout pregnancy, irrespective of any notional rights accorded to the foetus then as some point in the gestational process it is assumed that foetus becomes sufficiently human, by whatever means one chooses to make a determination, to be accorded certain rights, particularly the right to life, independently of the right of the woman. From that point onwards, the decisions as to whether an abortion may be morally and ethically justified, tolerated and, in law, permissible, entails a value judgement in which one takes into account and seek to balance the presumed rights of both parties.

To complicate matters further, in reaching such a judgement one must take into account both the relative merits of each parties claim to certain rights – i.e. should both the woman and the foetus be considered equal in overall status or do rights accorded to one take precedence over those accorded to the other? – and the relative merits of the specific right (or rights) at issue – i.e. does the foetus’s right to life override the woman’s right to choice?

Depending on one’s general perspective on abortion, one which place a different emphasis on the importance of these two questions. The religious view is that the right to life trumps almost any other consideration, such that with the occasional exemption (i.e. that usually included in relation to conceptions arising out an act of rape) one need consider the balance of rights only where there is significant risk of the woman dying should she continue with the pregnancy, and therefore only where conflict exists between the right to life accorded to both parties. By complete contrast, the strongest form of pro-choice view hold that the rights of the woman are pre-eminent over those of the foetus, irrespective of which particular right (or rights) might be at stake.

By and large, the mainstream view is somewhere in between these two positions and will seek to balance both elements of the equation, however, the is a strong general tendency to take the view that once the foetus has developed to the point at which rights are conferred upon it, those rights should be considered to generally equal to those of the woman, leaving only the balance of specific rights to be considered.

But is this necessarily a rational view to take? Not, if one considers the implications raised by the analogy with Schrödinger’s Cat, in its variant form, that I set out earlier.

Assuming one is dealing with circumstances in which both woman and foetus are considered to have rights independent of the other, the question arises as to whether those rights should be though, in general, to be equal in status, i.e. should both the woman and the foetus be thought to be equal is status as human beings?

Conventional wisdom might appear suggest that the answer is yes, and yet the fact remains that until such time as the foetus exists independently of its mother, i.e. outside the womb, it’s actual status is more akin to that of Schrödinger’s hypothetical cat in the sense that even with modern medical technology giving us the ability to assess and determine the status of the foetus at a given time point in time, its overall status remains to some degree indeterminate until such time as it is born and exists independently of its mother’s womb. In the case of the women we are dealing with an individual who is unmistakeably a human being, however in the case of the foetus, until such time as it is born, its status remains open to question and we are dealing not in absolute certainties but in probabilities, not least of which being the probability of the foetus surviving until (and past) the point of birth.

Unlike the hypothetical cat, however, these probabilities are not fixed by vary over time – all things being equal, the probability of survival increases over the period of gestation such that, logically, the status of the foetus become less indeterminate as time progresses, and this remains valid whether gestation proceeds in the womb as normal or interrupted before the foetus reaches full term and superseded by artificial incubation and until such time as the, by then, baby, is capable to sustaining its existence without intensive medical intervention.

When it comes to premature births, matters become even more complicated because while the fact of the foetus/baby’s existence outside the womb would be considered by near enough all to conclusively determine its status as a human being and therefore its right to be accorded rights independently of its mother, this affects only its metaphysical status and not its probability of survival, which, depending on exactly when birth occurs, may easily be substantially reduced in the process.

Here we have the uncomfortable paradox that lies at the heart of the question of foetal viability as a basis for judgements are to the moral, ethical and legal permissibility of abortion. While the foetus remains in the mother’s womb, its existence as a human being can only rationally (and scientifically) be measured in terms of its potential for survival and one is, therefore, dealing not in absolutes but in probabilities.

In seeking to set an upper limit on the time at which abortions may be permitted by law from such a reference point one must both assess the general probability of a foetus surviving premature birth at a particular stage in gestation and also, critically, whether that probability is sufficiently high to justify placing a restriction or prohibition on abortions beyond that point.

Should one reduce the upper limit for abortions to 20 or 22 weeks simply because a single foetus has survived successfully outside its mother’s womb from that point – is that sufficient proof of life to justify a limit on abortions at that point. Or does the survival rate need to be 1%, or 10%, or the 30-40% rate (at 24 weeks) currently being quoted by those who either oppose abortion outright or favour further restrictions – or maybe we should be ‘democratic’ about this and insist on at least a simple majority.

How does one rationally assess questions of this kind?

What I’ve tried to achieve here is to demonstrate that for all that arguments based on notions of ‘viability’ appear both persuasive, rational, and, crucially for many people, founded on medical science, in reality the concept of viability fails more or less entirely to provide a coherent and rational framework from which one can arrive at a rational judgement on setting an upper limit on access to abortions even without considering some of the many other ethical dilemmas that advances medical technology may eventually raise, not least of which is the possibility of developing an artificial womb that would allow gestation to take place entirely outside the human body or the development of foetal transplantation – both of which have explored at length by science fiction authors. It is a fundamentally flawed approach, as flawed, subjective and, in its own way, irrational as that which believes that life begins at conception on the back of the presumed but unverifiable existence of the human soul.

– – –

Getting back to the question of life, itself, or rather human life – as distinct from other species – if one is seeking a rational approach to questions raised by the issue of abortion then it would seem that one’s starting point must lie in the question of precisely when, and how, a foetus becomes definably human in nature and, therefore, acquires rights as an individual as distinct from its mother.

Perhaps the clearest possible indication of the failure of the anti-abortion lobby to sway public opinion by means of a purely moral argument based on the belief that life begins at conception is to found in the the extent to which anti-abortion campaigners have sought to use both shock tactics, i.e. images of aborted foetuses, in their campaign literature, while at the same time making assiduous use of any and all medical evidence that appears in any way to suggest that the embryo/foetus, even at an early stage in development, possesses identifiably human characteristics.

Hattersley, in his article, picks up one fairly typical example of such tactics, in noting that:

…the Most Reverend Peter Smith, Archbishop of Cardiff, claimed that pictures of a foetus apparently "walking in the womb" had "touched people’s hearts".

Propaganda of this kind invariably follows the same basic form, in which some physical characteristic present in foetus is held up as evidence of its ‘humanity’ in an effort to elicit a purely subjective and emotional response – albeit that the underlying science rarely, if ever, backs up such claims.

So it is with the apparent ‘walking’ foetus – at 15-18 weeks gestation a foetus certainly moves in the womb and may well move in a fashion which suggests ‘walking’, yet the fact remains that the foetus is actually walking – to walk implies conscious effort on the part of the foetus, effort which is entirely impossible at that stage of development as the foetus’s brain has not developed any actual capacity for higher cognitive functions at that point. The movements that the Archbishop of Cardiff is pointing to as evidence of the humanity of the foetus are, in fact, entirely automatic and without the merest shred of conscious intent.

Much the same problem – bad science – arises in another common myth promoted by the anti-abortion lobby, which claims that at around 12 weeks gestation, by which point the core central nervous system has developed, the foetus is then capable of ‘feeling’ pain. While it may certainly be true that once the central nervous system is in place, a foetus may experience and even physically respond to such stimuli, such responses are, again, entirely automatic. To actual ‘feel’ pain, in the sense understood by most people, again requires a degree of consciousness and higher cognitive function that is simply not present at such an early stage of development, such capacity does not, in fact, begin to develop until the third trimester (from 24 -26 weeks gestation) 24 weeks being the current upper limit on the general availability of abortion.

Central to these, and other related, issues is that most basic of all questions – what is the nature of humanity and how and when does it manifest itself during foetal development.

This is a more complicated question than might first be apparent as to be human, in a physical/biological sense does not necessarily equate to humanity in the metaphysical sense – a corpse is physically, biologically and genetically human and yet, being dead, could not be said to possess those qualities that, collectively, we would consider to be the defining characteristics of humanity. Other than a notional right to a decent and undisturbed burial/cremation, a corpse is accorded no particular rights at all, quite rationally, and even the right to burial/cremation has more to do with the sensibilities of living family and friends than the status of the corpse itself – which is entirely beyond caring what happens to it.

As sentient beings, our sense of humanity is not bound up in physical characteristics or even in the human genome. As a matter of routine we anthropomorphisise animals and even inanimate objects, vesting in them notional human qualities, and yet most of us would not even think of according them anything approaching human rights. Conversely as a society, for the most part, we have come to look beyond disability and deformity, physical differences from the norm that, historically, have often been held to compromise the status of the individual as a human being, and recognise that, at the very least, there is more to being human than appearance or physical capacity. Humanity – that which makes us definably human – if it rests anywhere rests in the mind, in cognition and consciousness, in our capacity to think, to reason, to feel, to communicate and in whole host of other abstract qualities…

…none of which are even capable of being present in a foetus before 24 weeks gestation, simply because that portion of the brain in which such higher functions ‘reside’ does not being to develop and function until that point in time.

This, in turn, raises another interesting metaphysical question – in ascribing to human beings a package of notional rights, to what element or aspect of being human do those rights attach?

Does one acquire these notional rights by virtue of one’s physical (i.e. genetic) characteristics or is the acquisition of rights based on more abstract notions of ‘humanity’, of the sum total of cognition and consciousness, of thought and emotion?

The answer to such a question has massive bearing on how one approaches the question of abortion as if one attaches right to the abstract rather than the physical notion of being human then the idea that a foetus possesses certain rights independent of and, at least, equal to that of its mother becomes, to a significant degree, moot until such time as the foetus begins to develop the physical capacity to ‘host’ those abstract qualities. While it is certainly not the case that one would argue that foetus does not become human until it starts to develop the capacity for higher cognitive functions, one can legitimately argue that until such point its capacity for humanity is sufficient indeterminate and undefined so as not to give rise to any notional right that might conflict with the rights accorded to the mother, including the right to undergo an abortion.

Viewed from this perspective, access to abortion up to the present 24 week limit on general availability is not only eminently reasonable but also in no way contingent on the capacity of medical science to sustain the life of a foetus ‘born’ prior to this point in gestation by artificial means – a rational, scientifically-founded argument in favour of reducing this upper limit would have to be based not on the perceived ‘viability’ of the foetus prior to this point or its presumed ‘capacity for independent life’ but on science demonstrating that basic cognition, and therefore, the clear capacity to develop those abstract qualities that we consider to constitute ‘humanity’, starts before this point.

Such an existentialist perspective on abortion – which incidentally also happens to be pretty much the way I see things – is not without it moral and ethical complexities both in terms of the question of what value one places on the potential that exists in the foetus prior to 24 weeks gestation, nor indeed does it resolve the complex issues arising out of late abortions on grounds of disability, although it does give added weight in support of permitting such abortions where the disability would impact significantly on cognitive function.

It does, however, have the twin virtues of being pretty much consistent with the established scientific understanding of foetal development and of seeking to establish parameters for debate that remain rooted in considerations of the nature of humanity and the moral value one ascribes to human beings and not in considerations of the technical prowess of medical science.

If it were genuinely as simple a matter as Hattersley suggests in stating that:

That incontrovertible imperative leaves parliament and government with only one task to perform: discovering when independent life is viable.

…then what need is there for parliament to investigate and consider this matter – if viability is genuinely to be the sole measure upon which legal access to abortion is founded, then parliament need only enact whatever recommendations may be put forward from time to time by the National Institute for Clinical Excellence or an ethics committee operating under the aegis of the General Medical Council, either of which would be far better qualified to make such assessments in terms of clinical evidence than the vast majority of parliamentarians.

But then there’s much more to be considered here than simply the matter of foetal viability, which is precisely why there must be an open public debate, if and when the current abortion laws are to be reviewed, why this is very much a matter for parliament and why, as has been the case certainly since the original Abortion Act of 1967, this remains and must remain subject to a free vote in parliament.

Discovering when ‘independent life is viable’ is most definitely not the sole task of parliament and government in this matter, it is not even its most important task, which is to ensure that full consideration is given to the multiplicity of views and opinions that exist in British society on the subject of abortion before make a determination on whether there is, indeed, a case for changes in existing law.

  • Excellent excellent post if I may say.

    I go through more moral anguish on this one than just about any problem I face in medicine. But however uncertain I feel about it, I cannot see any alternative but this being the mother’s choice.

    http://nhsblogdoc.blogspot.com/2006/02/abortion-in-south-dakota-pro-lifers.html

    John

  • Coming from you, John, that is a hell of a compliment.

    I should say that but for his error on viability there is much to like about the general tone of Hattersley’s argument – if we are to debate abortion such a debate should rest firmly on questions of humanity and not science or religion and should eschew hypocrisy at all all costs.

    As I said over at Owen’s blog, if our objective is to reduce the number of abortions, which is not a bad objective in itself, then our first recourse should be to sex education and access to birth control, the best ‘medicine’ being invariably of the preventative kind.

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