Abortion

Resources xTowardsapoliticalgeographyofabortion Ectogenesisargument Ifabortiontheninfanticide Ectogestationandabortiondebate

Resources

Calkin, S. (2019). Towards a political geography of abortion. Political Geography, 69, 22-29. Retrieved from

https://www.sciencedirect.com/science/article/pii/S0962629817304389

Rodger, D. (2020). Why Ectogestation Is Unlikely to Transform the

Abortion

Debate: a Discussion of ‘Ectogestation and the Problem of Abortion’. Philosophy & Technology, 1-7. Retrieved from

https://link.springer.com/article/10.1007/s13347-020-00436-1

Räsänen, J. (2017). Ectogenesis, abortion and a right to the death of the fetus. Bioethics, 31(9), 697-702. Retrieved from

https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12404

Hershenov, D. B., & Hershenov, R. J. (2017). If abortion, then infanticide. Theoretical medicine and bioethics, 38(5), 387-409. Retrieved from https://link.springer.com/article/10.1007/s11017-017-9419-7

Contents lists available at ScienceDirect

Political Geography

journal homepage: www.elsevier.com/locate/polgeo

owards a political geography of abortion

Sydney Calkin
Geography Department, Science Site, Durham University, Durham, DH1 3LE, UK

A R T I C L E I N F O

Keywords:
Abortion
Reproduction
Feminist political geography
Scale
Pregnancy

A B S T R A C T

This article introduces a political geography of abortion, arguing that abortion access is an essential but over-
looked site where gendered mechanisms of state control are enforced and contested. Today, abortion access is
currently in the midst of a significant spatial transformation: advances in technology, medicine, and activist
tactics are currently changing the geographies of abortion and working to weaken the link between access to
abortion and national legal frameworks. In response to these challenges to state control over reproduction, states
are responding with new tactics to re-assert authority over pregnancy and abortion. However, these changes
remain under-researched in the geographical literature, which tends to sustain a focus on state-law and inter-
state travel. The forces currently transforming abortion access exceed these analytical frameworks: we require a
multi-scalar and scale-jumping account of the relationship between pro-choice activists and anti-choice states.
This article makes the case for a political geography of abortion that moves beyond a state-based framework to
account for changing patterns of resistance and restriction on abortion. The arguments are developed through
two cases: mobile abortion clinics at sea and telemedicine abortion technology, both of which demonstrate the
contestation over abortion rights at the sub- and supra-state levels.

Reproduction is a core component of nation and state-making pro-
cesses, in which the alignment between population, territory, and
community is deliberately forged. Bodies are territories onto which
states project power, but reproductive bodies crucially “make territory”
in ways that conform to and resist dominant power structures (Smith,
2012, p. 1513). State control of reproduction is inextricable from po-
litical claims about the rightful occupants of a particular piece of ter-
ritory or the categories of citizen entitled to protections by the state. To
this end, state interventions to govern reproduction are always marked
by the coupling of pro-natalist and anti-natalist policies: to perpetuate
religious and/or ethnic divisions (Mayer, 1999; Smith, 2012; Smyth,
2005); to sustain an economic system by managing the growth of the
labour force (Cao, 2015; Kligman, 1998); or to mitigate against racia-
lized demographic change (Farris, 2017; Luibheid, 2013; Repo, 2015).
Everyday intimacies – sex, pregnancy, birth, care, and family-formation
– are foundational to political communities and are therefore managed
by more or less restrictive interventions.

What role for abortion in this reproductive political geography?
Abortion regulation is a site of social control where prevailing norms
about patriarchy, heterosexuality, motherhood, and citizenship are
enforced and contested (Calkin, 2018; Fletcher, 2007; Woliver, 2010).
Abortion has always been a feature of women’s lives, although it ac-
quired its status as a fiercely contested and widely criminalized offence
within the last 150 years. The criminalization of abortion took place in

the broader context of a turn to biopolitical governance across Europe
and North America, where government action targeted the level of the
population through interventions to shape the health, survival, and
capacities of the state’s people (Miller, 2013; Petchesky, 1984; Solinger,
2005). Abortion restrictions are implicated in natalist policies of all
varieties: draconian bans on abortion have historically been employed
to grow the population of particular national groups and preserve tra-
ditional gender roles (see Kligman, 1998; Luibheid, 2013; Solinger,
2005), while coercive and violent programmes of abortion and ster-
ilization have been used to curb population growth and enforce racia-
lized projects of control (Hartmann, 2016; King, 2002; Roberts, 1999;
Wilson, 2012). Opposition to abortion has even come to direct foreign
policy objectives, determining global public health goals and driving
development spending shifts, as in the Global Gag Rule (Brickell &
Cuomo, 2018; Sanger, 2017). Abortion politics must be read alongside
broader debates about citizenship, population, and the biopolitics of
fertility in which states undertake efforts to encourage particular modes
of reproduction at home and abroad.

Abortion access today is in the midst of a significant spatial trans-
formation driven by medical and technological changes. These changes
have profound political and geographical implications because they
signal the growth of a trans-national and extra-territorial set of actors
and flows that are expanding abortion provision outside of state legal
frameworks. This paper offers a political geography account of

https://doi.org/10.1016/j.polgeo.2018.11.006
Received 9 December 2017; Received in revised form 20 July 2018; Accepted 19 November 2018

E-mail address: Sydney.calkin@durham.ac.uk.

Political Geography 69 (2019) 22–

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https://www.elsevier.com/locate/polgeo

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mailto:Sydney.calkin@durham.ac.uk

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abortion, arguing that the changing spatiality of abortion access reflects
a significant shift in the relationship between women, the state, and
reproduction. To this end, the paper brings together political geography
scholarship on scale and state power with feminist geography of re-
production to augment understandings of both. Political geography
scholarship has seriously overlooked abortion, although the issue is
central to state-led efforts to manage reproduction, population, and the
gender order. The ongoing contestation over abortion access speaks to
debates in the discipline about the de- and re-territorialization of state
power because control over abortion has come to implicate questions of
sovereignty and territorial control. Meanwhile, the extant geographical
literature on abortion cannot account for the current spatial transfor-
mation of abortion, because this literature sustains an understanding of
abortion as a matter of state law and cross-border travel. In order to
understand the changing political geography of abortion, the paper
argues, our analysis can no longer concentrate on the state as a terri-
torial container for abortion law, but it must take into account a more
fluid and multi-scalar infrastructure for abortion access outside of state-
sanctioned clinic space.

The article proceeds in four parts: first, it maps the changing spa-
tiality of abortion by tracing the traditional medical and state infra-
structures that govern abortion and the emergent patterns of abortion
mobility that work outside of these spaces. Second, it turns to the po-
litical geography literature on scale to conceptualize the modes of
multi-scalar resistance and state re-scaling that characterize this con-
testation over abortion. Third, it demonstrates that pro-choice activists
make use of mobile and digital clinic space to scale-jump and harness
scale for political claims. Fourth, it shows that anti-abortion states have
instituted a range of spatial techniques to obstruct mobile and scale-
jumping forms of pro-choice activism, especially by imposing greater
regulation on the doctor-patient interaction. It concludes by mapping
future directions in research on the political geography of abortion.

States, clinics and reproductive space

A political geography of abortion starts from the contention that
abortion is a spatial phenomenon. Its regulation has traditionally pro-
ceeded through state-imposed boundaries on when and where it could
take place, granting doctors exclusive authority over legal termination
of pregnancy. Across the diverse historical and geographical contexts in
which abortion has been criminalized and legalized, this has been en-
forced through a spatial logic of medical control. The criminalization of
abortion was politically driven by state-led projects to manage fertility
rates, but in practical terms it was made possible with the support of
anti-abortion medical associations and through the increased surveil-
lance of doctors over pregnancy. The legalization of abortion was si-
milarly facilitated with the support of the medical establishment and
through the preservation of medical authority (see Reagan, 1998;
Petchesky, 1984; Luker, 1985). Across most of the countries where
abortion is legally available today, doctors may provide legal abortion
inside formal medical spaces but states maintain criminal penalties for
abortions obtained outside of this medical context.1 This is still the case
in Britain, for example, where abortion can be legally granted with two
doctors’ approval under the 1967 Abortion Act but is otherwise crim-
inalized under the 1861 Offences Against the Person Act (Sheldon,
1997). States which permit abortion have generally done so by granting
doctors the sole authority over legal abortions and implementing cor-
responding restrictions through criminal law, medical regulations, and
a range of policy domains (Erdman, 2017). Access to legal abortion
therefore depends on authorized medical supervision inside designated

clinic spaces, while abortions outside of this context are criminalized.
States with abortion bans, by contrast, often permit women to go
abroad for abortion without prosecuting them upon their return (see for
example, Fletcher, 2013). These states attempt to symbolically enact
the status of the ‘abortion-free territory’, albeit with the expectation
that neighbouring jurisdictions will provide abortions for women who
can travel.

Abortion travel has therefore been a central feature of abortion
access past and present. In political geography terms, this means re-
cognizing that abortion access often implicates the legal contexts of
sub- and supra-state entities. Abortion travel is essential for women in
federal or devolved systems that produce a patchwork of laws within a
single political entity such as Canada, the USA, the UK, Australia, and
Mexico (Berer, 2017; Brown, 2013; Gilmartin & White, 2011; Sethna &
Doull, 2012; Whitaker & Horgan, 2016). Across international borders,
‘abortion corridors’ arise between neighbouring countries with different
legal regimes or similarly restrictive laws but different levels of en-
forcement: these corridors include Ireland-England, Germany-Poland,
USA-Mexico, and Chile-Peru, among others (see Brown, 2013; Calkin &
Freeman, 2018; Fletcher, 2016; Freeman, 2017; Side, 2016). Women
who must travel for abortion face numerous barriers, of which political
and economic obstacles often loom the largest. First, crossing borders
for an abortion requires a woman to have a passport and visa to freely
leave and enter another country. Women who are refugees, asylum
seekers, or undocumented migrants often lack this documentation and
the money required to obtain it (Gilmartin & Kennedy, 2018;
Haksgaard, 2017; Side, 2016). Second, crossing large distances for
abortion also requires a woman to have substantial financial means,
access to transport, access to childcare, and a social support network to
facilitate the trip (Pruitt, 2007, 2008; Sethna & Doull, 2012). Because
abortion travel obstacles map onto existing socio-economic inequalities
and layer up in place-specific ways, distance-based obstacles to abor-
tion are often underestimated in ways that disadvantage poor and rural
women (Pruitt & Vanegas, 2015; Statz & Pruitt, 2018). Abortion access
via travel depends on numerous inter-linking factors that extend well
beyond the laws of nearby jurisdictions: access in practice is contingent
on women’s mobility, socio-economic context, social networks and
other structural obstacles.

Despite these insights into abortion travel, the current literature on
abortion geographies is limited by its reliance on a conceptual frame-
work that centres state law and imagines abortion access as contingent
on a woman’s mobility between different abortion jurisdictions. Though
it gives consideration to the gap between the law in theory and in
practice, the extant abortion geographies literature is underpinned by
the assumption that abortion access depends on a woman’s physical
presence in an abortion clinic, thus the emphasis on barriers to abortion
travel. This focus can obscure more important trends from view because
today abortion access is becoming less connected to physical clinic
spaces and, by extension, less tethered to national legal frameworks.
The main driver of this change has been medication abortion with pills
– mifepristone and misoprostol – that provide a safe non-surgical option
for early abortions. Medication abortion pills are already widely
available in Latin American on the black market and their impact on
reproductive health has been transformative (see Oberman, 2018).
First, the safety of self-managed abortion with pills has “turned on its
head” the conventional relationship between the safety and legality of
abortion (Jelinska and Yanow, 2018, p.87). The narrative of the ‘back
alley abortion’ evokes the notion that self-managed or clandestine
abortion is, by its very nature, dangerous to a woman’s health. By
contrast, the World Health Organization has found that self-managed
abortion with pills, assisted by online medical consultation from a re-
putable provider, qualifies as a safe abortion (Ganatra quoted in
Boseley, 2017). Second, the simplicity and safety of medication abor-
tion pills means that lay activists and feminist networks can provide the
necessary information for their use where restrictive abortion laws
prevent doctors, nurses or midwives from advising patients (Coeytaux,

1 The only jurisdictions in the world where abortion has been removed from
the criminal code are Canada and five Australian states/territories: the
Australian Capital Territory, Victoria, Tasmania, Queensland and the Northern
Territory (see Berer, 2017).

S. Calkin Political Geography 69 (2019) 22–29

Hessini, & Allina, 2015; Gomperts, Jelinska, Davies, Gemzell-
Danielsson, & Kleiverda, 2008). Third, because a medical abortion takes
place inside a woman’s body and “is not ‘carried out’ or ‘conducted’ by
someone else”, medication abortion can give women autonomy over
the process (Berer & Hoggart, 2018, p. 1; Winikoff & Sheldon, 2012).
The public health and medical literature on medication abortion has
welcomed this transformation in clinical practice, but as yet there has
been little consideration given to its political and geographical ramifi-
cations.

Ireland provides a concise example of the broader changes in
abortion mobilities, where self-managed abortion with pills has swiftly
transformed access patterns. Under the state’s near-total abortion ban in
force until 2018, many thousands of Irish women accessed abortion by
travelling to England. At the highest point in 2001, eighteen women per
day travelled from Ireland to England for abortion; as of 2016, that
number had fallen to just under nine per day (IFPA, 2018). This de-
crease in travel has been attributed to the increase in access to illegal
abortion pills through online pro-choice networks which facilitate the
distribution of pills inside Ireland (Sheldon, 2018). One online provider
reported that, between 2010 and 2015, three to five women in Ireland
requested abortion pills every day (Aiken, Gomperts, & Trussell,
2017).2 The recognition that abortion pills were being widely accessed
in Ireland, despite the threat of a fourteen-year prison sentence for their
use, was instrumental in pushing the Irish political mainstream towards
a more permissive approach to early abortions in the lead up to its 2018
abortion referendum. Given the widespread access to abortion pills in
Ireland, laws banning their use have been and would likely continue to
be practically and politically unenforceable (Sheldon, 2016). To this
end, much of the pro-choice political discourse of mainstream Irish
politicians emphasized the danger of clandestine abortion with pills and
the need to liberalize the law so these pills could be brought back under
medical control (see for example Leahy, 2018). Abortion mobilities in
the Irish context are often associated with flows of cross-border abor-
tion-seekers and territorial narratives of ‘abortion-free Ireland’ but the
increased access to abortion pills and their impact on the political
landscape point to the limitations of a travel-centred account.

The geography of abortion access is in the process of transforma-
tion, yet the current efforts to conceptualize these changes tend to focus
on the state jurisdiction to the exclusion of other relevant spaces. A
geographical orientation to abortion shows us that contestation over
abortion is about the management and regulation of space at multiple
scales. State control over abortion has governed through the clinic
space and the doctor-patient interaction, assuming that the key ele-
ments of abortion access were co-location of patient, doctor, clinic, and
medical equipment. Consequently, the transformation that abortion
pills bring about is an alternative spatial arrangement that moves access
beyond the clinic space. This opens up a range of possibilities for pro-
choice activists to move abortion access into new spaces while it also
poses a serious challenge to the state’s ability to limit where and when
abortion takes place. Abortion’s spatial transformation requires us to
think beyond the legal frameworks of states and the mobility of abor-
tion travellers between jurisdictions, to conceptualize the mobility of
abortion pills, information, and delivery technologies in new ways. It
demonstrates the need for an alternative and multi-scalar analytical
framework that draws on political geography insights into scale and
territoriality but also works to challenge political geography to con-
ceptualize the regulation of abortion as a significant site of state-
making.

Re-scaling abortion access

A political geography of abortion takes the feminist critique of scale
as a starting point, building from this critique to note the ways in which
pro-choice feminist activism has deliberately employed and subverted
scalar categories to make political claims about state power and female
autonomy. Feminists have demonstrated that scale’s categories are in-
herently political because scholarship on scale often has the effect of re-
producing masculinist assumptions about what ‘counts’ as political, by
concentrating analysis on certain processes, places, and actors
(England, 2003; Marston, 2000; Pain, 2009). Conventional scalar ca-
tegories are premised on gender binaries and often reinforce and nat-
uralize the spatial separation of the masculine public realm and femi-
nine private sphere, although scales like the domestic and corporeal are
in fact “profoundly entwined” with the geopolitical (Dowler & Sharp,
2001; Pratt & Rosner, 2012). Moreover, because these spaces are in-
scribed with geographical, political, and legal significance, a feminist
account must strive to overcome the binary thinking that structures the
literature and account for the intimate and the geopolitical in “a single
complex” (Brickell & Cuomo, 2018, p. 2). Pro-natalist policies that re-
strict abortion serve material and symbolic functions, reflecting efforts
to shape population and national identity (see for example Kligman,
1998; Luibheid, 2013); as such, they exemplify the feminist claim that
the corporeal and geopolitical are inseparable. Emergent modes of
mobile abortion access offer a way to extend this critique: feminist ef-
forts to expand abortion access strategically embrace and politicize
scale in order to expose the limits of state interventions to control re-
production.

Geographers have widely critiqued scale, noting its tendency to re-
impose conceptual hierarchies and fit different phenomena into a set of
pre-existing scalar categories (Marston, Jones, & Woodward, 2005;
Paasi, 2004). Particular scales can easily become entrenched platforms
for analysis: this is evident in the over-reliance on state-level analysis in
the existing geographical literature on abortion. Amidst these scale
debates have been calls for the recuperation of scalar thinking as a tool
for analysis, insisting on the possibility of researching through scalar
thinking without internalizing and accepting scalar categories as nat-
ural. This entails approaching scale not just as a social construct but a
political construct: how are scales constructed and legitimized by states
or other actors? In this view, scales can be understood as political
projects that are specifically deployed by actors to “crystallize certain
socio-spatial arrangements” or to further political aims (Moore, 2008,
p. 218). Acknowledging the political uses of scale, scalar analysis can
look for its strategic deployments and effects, rather than employing
scale purely as an analytical tool that is imposed upon the data. Political
actors are generally interested in control over particular areas of ac-
tivity or policy, “rather than the command of scale per se” so they seek
to manipulate “discursive and material” aspects of scale to pursue their
agendas (MacKinnon, 2011, p. 30). This political orientation to scale is
a productive path forward in the scale debates, in part because it by-
passes the ontological question of scale’s existence and offers us a view
of scale as a political tool that is created through human action and
employed for deliberate ends.

By extension, an account of multi-scalar resistance calls attention to
the way that scales are politically constructed, employed, and trans-
formed to produce a desired set of outcomes. Neil Smith has labelled
this “jumping” or “bending” scales: it is a form of resistance in which
actors deliberately violate socio-spatial boundaries in order to make
political claims about space, power, and position. The act of jumping
between scales highlights the connection of different scales, while
“dissolving” and “abrogating” the boundaries between them (1992,
p.60). Beyond violating spatial boundaries, scale-jumping and bending
can work by redefining the power relations between different scales or
challenging the assumptions about what activities happen at particular
scales (Smith, 2004). Resistance through scale-jumping works to build
alliances between actors who are differently placed in relation to the

2 This number represents only a fraction of the actual daily demand for
abortion pills, because it reflects requests made to one of several online net-
works that provide pills in Ireland. In addition, women in Ireland source pills
through online pharmacies and informal personal networks.

S. Calkin Political Geography 69 (2019) 22–29

state and use their positions to leverage pressure and produce a new
policy or policy reversal. This might mean asserting the importance of
particular scales and diminishing the importance of others in relation,
forging closer connections between particular scales to achieve an
outcome, or contesting dominant power structures by multi-directional
scale jumping that challenges the presumption of ‘upward’ movement
(Cox, 1998; Swyngedouw, 2000). Scale-jumping offers activists a way
to point out the fictive and constructed nature of scales while using
material manifestations of scale to make political statements.

Forms of resistance that creatively violate spatial boundaries may
work to subvert the established structures of political power, but they
are inevitably contested. Processes of political transformation that
contest state power prompt its spatial re-arrangement, rather than its
obliteration. Scalar literature on globalization uses this dialectical re-
lationship to explain the interplay between de-territorializing forces of
capitalism that seek to compress space and time, against the re-terri-
torializing efforts of political entities that re-configure their power in a
variety of spatial forms (Brenner, 1999). Where state territorial control
is challenged or eroded, states work to reproduce the rationality of
territory across diverse scales (Elden, 2005; Shah, 2012). Multi-scalar
modes of resistance that strive to work outside of familiar political
entities are still anchored in fixed infrastructures and are always subject
to place-based interventions to govern them as such. This critique might
be understood as tempering the optimism around multi-scalar re-
sistance, by drawing attention to the way that state power is re-asserted
and re-scaled in response to scale-jumping challenges. With reference to
abortion access, pro-choice activism that jumps scale to deliberately
violate spatial boundaries and offer new platforms for digital or mobile
abortion access is interpreted as a challenge to state authority, and
states respond as such. The multi-scalar infrastructure of self-managed
abortion is continually contested and efforts to govern it are made by
states who re-scale their power to enforce abortion restrictions.

The conceptual tools of critical scale literature help to account for
the changing relationship between women, the state, and reproduction.
The transformation of abortion’s spatiality has been the deliberate re-
sult of action by pro-choice activists who have leveraged the mobility of
medication abortion pills to subvert state laws and provide wider access
through creative scalar strategies. In the different iterations of pro-
choice activism, there is an evident re-scaling of abortion that pro-
gressively reorganizes abortion to move it outside of state control first
by moving it outside of formal medical spaces. In the first instance, the
feminist networks that facilitate abortion travel have expanded access
by moving women to clinics, providing money, transport, and in-
formation to lower the barriers to access. Extending this vision of
abortion travel, pro-choice networks have employed mobile medical
clinics to invert this relationship and move the abortion clinic space to
women in states with highly restrictive laws. Yet, persistent state in-
terventions obstruct the function of mobile clinics by placing territorial
obstacles between women and clinic spaces. As such, trans-national
digital abortion networks transcend the need to facilitate co-location of
women and clinics by offering access to an online clinic space that
provides medical consultation via email or video and access to mobile
medication abortion pills through the post.

Mobile and digital clinics

The spatial re-arrangement of abortion access has come about
through calculated efforts to violate state law, expose ‘loopholes’ in the
law, and establish clandestine networks for the distribution of medi-
cation and information. The Dutch NGO Women on Waves and its sister
organization Women on Web have been central to this endeavour. Since
2001, Women on Waves has staged high-profile campaigns to provide
abortions in a mobile clinic aboard a ship in international waters. In its
ship campaigns, the organization uses the legal status of ocean space to
subvert the abortion laws that operate on land because, under inter-
national law, territorial waters only extend 12 miles off the coast

beyond which point passing ships are governed by the laws of the
country in which they are registered (Jones, 2016). Under this system, a
Dutch-flagged ship positioned 13 miles off the Polish coast is governed
by the laws of the Netherlands, not Poland; in relation to abortion law,
this means physicians can prescribe and dispense medication abortion
pills to patients on board, regardless of the patient’s nationality
(Lambert-Beatty, 2008). In its ship campaigns, the organization docks
and brings abortion-seekers onto the ship at which point it sails into
international waters and the doctor on board dispenses medication
abortion pills to the women; no surgical abortions are provided. Women
on Waves’ ship campaigns exemplify a strategic deployment of scale,
because they creatively jump scales to access the legal regime of one
state in ocean space off the coast of another. In doing so, the organi-
zation is able to move bodies across metaphorical national spaces
without travelling those distances. Women on Waves strategically
constructs a space for abortion provision that exists in a state of legal
and geographical limbo: the fictive nature of this political scale is part
of its innovation. As soon as the ship sails away, taking the mobile clinic
with it, the space will cease to exist, as will the mode of abortion access
it provided.

Ocean space exhibits a “legal pluralism” that results in complex and
overlapping modes of governance: activists can make use of this space
to subvert the laws in force on shore, although states also employ a
variety of legal strategies for extending control over vessels outside
coastal waters (Peters, 2011, 2014). Women on Waves’ ship campaigns
have been consistently met with state efforts to obstruct them, whether
military or bureaucratic in nature. Portugal, for instance, met Women
on Waves’ vessel with warships to block its entry to coastal waters while
Guatemala used military personnel to prevent the Women on Waves
crew from disembarking or sailing out with Guatemalan women
(Women on Waves, 2004, 2017). On other campaigns, state withdrawal
of the mobile clinic’s medical authorization has prevented the group’s
doctors from treating patients (Lambert-Beatty, 2008; Sheldon, 2016).
These state-imposed obstacles, alongside numerous logistical con-
straints, mean that Women on Waves’ ship campaigns can serve rela-
tively few women during the brief windows when the ship and its
mobile clinic are in use. Nonetheless, these limitations have gone lar-
gely unnoticed by media and the public: since its first campaign in
2001, widespread media coverage of the ship campaigns has con-
tributed to the misconception that the ship is a permanent fixture of the
abortion landscape, continually sailing from port to port and providing
many women with abortion access. This presented an opportunity for
the organization:

“We got a lot of emails from all over the world that [women] needed
help, they wanted to know when the ship was there, but of course
there was no ship.3 So that’s why we started Women on Web. It’s just
a pill: you must be able to send it, so we found the loopholes to do it”
(Interview, Women on Waves, 2018).

The mobile clinic at sea brings an abortion clinic to women, by
creatively interpolating the legal jurisdiction of an abortion-permissive
state just outside the territorial control of an abortion-restrictive state.
Nonetheless, the venture still depends on its ability to physically bring
women on board, off shore, and into the mobile clinic, creating nu-
merous opportunities for state interference. Women on Waves has
therefore re-oriented its strategy to capitalize on the mobility of the
abortion pill and launched a second organization, Women on Web,
whose sole focus is to provide medication abortion pills and medical
consultation through the internet. The online service is staffed by a
team of doctors, all of whom are registered to practice medicine in
jurisdictions where abortion is de-criminalized. When a woman

3 The interviewee says “there was no ship” to mean there was no single vessel
in continuous operation sailing around the world. For most ship campaigns,
Women on Waves rents a ship.

S. Calkin Political Geography 69 (2019) 22–29

contacts the website, she has an online consultation with a doctor who
can then write her a prescription for abortion pills; the pills are sent to
the woman who continues to receive medical advice online while she
takes them. At one time, Women on Web filled orders for abortion pills
with an Indian pharmacy who shipped directly to the destination
country, but as customs agencies began to seize packages from online
pharmacies, activists developed alternative strategies (Bazelon, 2014;
Gomperts, 2017). In some cases, Women on Web affiliates fill the pre-
scriptions legally in European pharmacies and re-package the pills be-
fore sending them onwards; sometimes the packages can be sent
through to states without legal abortion, while in other cases they are
sent to neighboring states and physically smuggled across the border by
local activists (Gomperts, 2017; Sheldon, 2016; Sheldon, 2018). De-
pending on the destination country and its laws, the organization
modifies shipping routes or draws on local activist networks to move
pills to the women who request them. The trans-national network op-
erates remotely to advise women who contact the website, but the
physical work of securing access to pills employs a similar strategy for
scale-jumping that strategically sits inside some national jurisdictions in
order to subvert the laws of others.

Women on Waves has pioneered a mode of feminist geo-legal re-
sistance that makes use of “digital and floating worlds” where legal
infrastructures can be contested and shaped to achieve feminist ends
(Brickell & Cuomo, 2018, p. 10). The two organizations, Women on
Waves and Women on Web, are deliberately based in different jur-
isdictions whose legal and medical context is best suited to their re-
spective missions (Interview, Women on Waves, 2018). However, their
operations are designed to be mutually reinforcing while legally dis-
tinct. The logistical shortcomings of ship campaigns mean that on-the-
ground provision of pills must take alternate, clandestine routes, but the
intense media coverage of ship campaigns can be used to increase
awareness of, and demand for, abortion pills. In Morocco, for example,
Women on Waves’ ship campaign was designed to leverage the Mor-
occan authorities’ response and media coverage for a greater regional
impact. When no Moroccan women were able to board the ship, Women
on Waves instead used the attention of Arabic-language regional media
like Al Jazeera to explain that medication abortion pills are sold
cheaply in local pharmacies as arthritis medication (Gomperts, 2017).
This kind of media attention allows for symbolic scale-jumping,
spreading information across a region and language community. Simi-
larly, when states respond with military power, Women on Waves uses
this to communicate a feminist message about the state’s control over
women. In Guatemala, authorities locked the Women on Waves crew
inside the port and tasked the army with policing their movements.
Because it attracted so much local media attention, the state’s militar-
ized response sent a useful political message for Women on Waves:

“The army is not very popular and so the fact that the army would
intervene into something that was totally considered as a [marginal]
woman’s rights issue … people suddenly realized: ‘hey, if the army is
so interested in this, it’s about fundamental freedoms!’” (Interview,
Women on Waves, 2018).

Women on Web strategizes to provide women with medication
abortion by offering access to a digital clinic, while Women on Waves is
oriented more towards political statements that use ships, as well as
drones and robots,4 to move pills across political borders and highlight
the arbitrary boundaries that govern abortion. These actions alternately
make use of the state’s jurisdiction to offer legal cover for some aspects

of the work and stage attention-seeking stunts to goad the state into a
public response. By treating these scales as discursive and material, the
forms of multi-scalar resistance exemplified by Women on Waves
challenge the normal scalar arrangement of political activities at dif-
ferent levels. Ship campaigns politicize ocean and border space by
highlighting the tenuous boundaries between jurisdictions with dif-
ferent abortion laws; when the material limitations of ship campaigns
prevent Women on Waves from providing substantial access to large
numbers of women in need, the group instead uses the political and
media attention directed at the issue to lobby for reform and dis-
seminate information about other modes of access. Ship campaigns
offer a discursive platform for the critique of state control over re-
production, but a less direct material intervention to transform abortion
access. By contrast, Women on Web uses an online platform to provide
access to medical consultation and a shifting set of postal routes and
local affiliates to move pills into abortion-restrictive territories. Both
organizations demonstrate a politicized orientation to scale by drawing
attention to the arbitrary nature of state control and the physical limits
to its power and a scale-jumping strategy that deliberately combines
elements of multiple jurisdictions to construct transnational modes of
abortion access.

Telemedicine and medical surveillance

If the regulation of abortion has historically relied on the medical
authority and legal liability of doctors to enforce the state’s laws, how
can those laws be enforced when a pregnancy can be safely terminated
at home with pills obtained online? This question is a geographical one:
flows of medication abortion pills and access to abortion outside of
formal clinic settings has destabilized the state’s ability to strictly
control the conditions of termination of pregnancy. As pro-choice ac-
tivists employ politicized scale-jumping strategies that work to expand
provision in practice, they offer an alternative geography of abortion
access. In response, some abortion-restrictive states have approached
the issue as one of serious territorial violation that requires crim-
inalization and prosecution of clandestine abortion.5 Multi-scalar
modes of pro-choice resistance harness mobile abortion technologies to
subvert state abortion law, but these efforts are inescapably anchored in
place-based infrastructures and vulnerable to intervention. When
abortion mobilities offer new modes of access, state authorities have
sought to re-assert the power to govern (and prevent) abortion by in-
stituting a range of spatial counter-strategies that control the space of
the clinic, the medical consultation process, and the body. The en-
twined processes of activist scale-jumping and state re-scaling are il-
lustrated in the contestation over telemedicine abortion in the United
States of America where states have taken steps to control the flow of
medication abortion pills by imposing regulations on doctor-patient
consultations and mandating surveillance of pregnancy and mis-
carriage.

Although the right to access abortion is constitutionally protected in
the USA, in practice access varies dramatically across the country as it is
subject to increasingly draconian state-level restrictions. American op-
ponents of abortion have concentrated their efforts on “chipping away”
at access on the ground rather than mounting constitutional challenges
(Sanger, 2017; Siegel, 2007). Numerous measures to restrict abortion
have been introduced at the state (rather than federal) level, using a
variety of regulatory strategies to ban certain procedures, regulate

4 Since 2015, Women on Waves has conducted several ‘drone actions’ and
‘robot actions’ where it uses these technologies to move a few packs of abortion
pills across political borders or inside territory where the pills are illegal. These
actions do not provide access for local abortion-seekers. Instead, Women on
Waves activists take the pills in front of local media to protest restrictive laws
(Gomperts, 2017).

5 However, state responses to the influx of illegal abortion pills are not uni-
form. Some states, like the Republic of Ireland, have responded with a “chor-
eographed ignorance” and unwillingness to prosecute individual women
(Sheldon, 2018). By contrast, authorities in Northern Ireland have prosecuted
several people for the crime of procuring abortion pills. More research is needed
to account for the differences in official responses to the proliferation of
abortion pills, because they vary significantly depending on context.

S. Calkin Political Geography 69 (2019) 22–29
26

medical care, and impose restrictions on abortion clinics. Most promi-
nently, laws known as Targeted Restrictions of Abortion Providers
(TRAP) have tried to regulate clinics out of existence by requiring on-
erous administrative and structural changes to the clinic (see
Guttmacher Institute, 2018). Although some TRAP laws in Texas were
ruled unconstitutional by the Supreme Court’s 2016 ruling in Whole
Women’s Health vs. Hellerstedt, this decision did not automatically in-
validate TRAP laws in force in 24 other states (Yang & Kozhimannil,
2017). As such, abortion restrictions continue to close clinics and re-
strict their operation: for example, there are twenty-seven cities in the
US that qualify as “abortion deserts” because their nearest clinic is over
100 miles away (Cartwright, Karunaratne, Barr-Walker, Johns, &
Upadhyay, 2018). In practice, these geographical barriers become class-
based obstacles: the absence of public transport in rural areas, for in-
stance, means that travel to a far-away clinic requires an abundance of
money and time that poor and rural women disproportionately lack
(Pruitt & Vanegas, 2015).

In response to these obstacles, and in an effort to make abortion
more accessible to women who live far from abortion clinics, pro-choice
organizations have sought to increase access through telemedicine
technology. In telemedicine abortion, a woman’s consultation with her
doctor is conducted by video, phone, or online chat and medication
abortion pills are prescribed remotely. This can involve varying levels
of technology: in the most basic circumstances, telemedicine can mean
a phone call or web chat between a pregnant woman and a lay activist
who advises her on the safe use of medication abortion pills (Aiken
et al., 2017). In the most formal and technologically advanced settings,
telemedicine involves a remote communication between a doctor and
patient, where the patient receives basic care and preliminary tests at a
local medical facility but her prescription is provided by a doctor via
video chat. In some Planned Parenthood facilities in the USA, the doctor
can remotely unlock a medicine drawer in front of the patient and
watch while she takes the prescribed pills (Yang & Kozhimannil, 2016).
There is an important distinction between these different forms of tel-
emedicine: the informal online telemedicine service provided by groups
like Women on Web is generally regarded as illegal, because it provides
abortion pills to women in states where abortion is a criminal offence
(Sheldon, 2018). By contrast, legal telemedicine services like those in
the USA operate in states were abortion is legally permitted but difficult
to access. Telemedicine abortion has been found to improve access for
rural women, but it can also address clinic closures and staffing
shortages that leave urban and sub-urban women hundreds of miles
from the nearest clinic (Aiken et al., 2017; Grossman & Grindlay, 2017;
Pruitt & Vanegas, 2015). By providing a technological workaround for
the growing distances between American women and abortion provi-
ders, telemedicine offers a spatial fix for a geographical problem.

This spatial transformation of abortion has serious implications for
the state’s ability to permit or prohibit it and provokes a range of state
responses that aim to re-territorialize power. One such response is the
move to prohibit legal telemedicine in a formal medical setting: state
efforts to exert control over legal telemedicine abortion are generally
scaled at the level of the medical facility, demonstrating an effort to re-
assert clinical control over abortion and state control over clinics. Some
states have taken a direct route, legislating an outright ban on tele-
medicine by mandating in-person contact between doctor and patient
and prohibiting “the use of telehealth or telemedicine services” (quoted
in Kreutzfeld, 2016, p. 79). Others have sought to effectively ban tel-
emedicine by requiring multiple in-person visits with a doctor for the
prescription of medication abortion pills (see Hooper, 2014).6 Prior to

2016, states could do this by requiring medication abortion be provided
according to a federal protocol that mandated three in-person visits to
the doctor for the use of medication abortion pills, including two visits
to take the pills at separate times and one additional visit for follow-up
care (Pruitt & Vanegas, 2015). Separate from this protocol, some states
specifically require in-person visits for pre-abortion counselling or re-
quire an ultrasound which must be performed by the doctor who will
perform the abortion (Lindgren, 2017). Many restrictions on tele-
medicine work by mandating the space of the physician-patient inter-
action: twenty-one states currently have these laws in force. Fourteen
states specifically require the doctor be “physically present” or “in the
physical presence” of the patient when the medication abortion pills are
dispensed; nine of these states additionally specify they must be “in the
same room” (Guttmacher Institute, 2018).7 Most recently, Arkansas
introduced a measure to require doctors who prescribe medication
abortion pills to have reciprocal privileges at nearby hospitals, although
this requirement is notoriously onerous and medically unnecessary (see
Cartwright et al., 2018). In short, the legal workaround of mobile
abortion technology has been met by anti-choice states with territorial
strategies to regulate clinic spaces, circumscribe physical interaction
between doctor and patient, and reimpose geographical obstacles to
care.

For women who cannot access medication abortion pills through
legal channels, other routes exist. American women can access informal
telemedicine services through online networks that provide advice on
safely self-managing abortion or they can buy medication abortion pills
through online pharmacies (Murtagh et al., 2018; Aiken, 2018). Both of
these routes are illegal and carry significant legal risk for pregnant
women: many states explicitly criminalize women who perform their
own abortions and characterize abortions outside of a formal medical
context as feticide (Kreutzfeld, 2016; Lindgren, 2017; Rowan, 2015).
The prohibitions against self-induced abortion are scaled at the level of
the medical clinic and the doctor-patient interaction, so women face the
greatest risk of detection when they come into contact with medical
services. Online telemedicine services generally advise women that
doctors cannot definitively detect whether a miscarriage has occurred
naturally or has been induced with pills, so long as the pills are ad-
ministered orally and not vaginally. Nonetheless, law enforcement in-
creasingly “relies on medical professionals’ reporting to the authorities
women whom they suspect may have had a self-induced abortion”
(Rowan, 2015, p. 73). This includes reporting women who admit to
having attempted abortion as well as women who present at hospitals
with symptoms of miscarriage, but whom a doctor suspects has an at-
tempted abortion. Prosecutions of women for self-induced abortion are
on the rise in the USA (Diaz-Tello et al., 2018).8 This is, in part, because
medical staff are also criminally liable for reporting suspected abor-
tions: medical staff who fail to report self-induced abortions have been
charged with tampering with evidence, obstruction of justice, and
failing to report an abortion (Diaz-Tello et al., 2018).

Advances in telemedicine abortion technology and the legal moves
to curtail telemedicine abortion provide vivid examples of abortion
politics as a struggle over the spatiality of state power. Activist efforts to
jump scale and bridge space are met with reciprocal efforts by states to
institute new obstacles that re-territorialize power, albeit at different
scales. When lawmakers cannot ban abortion within a given state, they
take steps to create laws that effectively prevent it by eliminating any
legal spaces for clinics and doctors to operate. The state’s ability to
regulate clinic space is eroded when mobile clinics at sea can provide
temporary access offshore and telemedicine technology can provide

6 As with so many other abortion restrictions, the prohibitions against tele-
medicine are often framed as “woman protective” restrictions (Siegel, 2007).
Anti-choice groups and legislators refer to telemedicine as ‘webcam abortion’ to
emphasize the perceived danger of women taking abortion pills outside of a
designated clinic space.

7 See, for example: Arkansas, A.C.A. § 20-16- 603 (2016); Kansas, K.S.A. § 65-
4a10 (2011); Mississippi, MS S.B.

95 (2013); Wisconsin, Wis. Stat. Ann. §
253.105 (2015–6).

8 Such criminal surveillance of pregnant women by medical staff has long
been a part of the American ‘War on Drugs’ (see Roberts, 1999).

S. Calkin Political Geography 69 (2019) 22–29
27

remote medical advice over long distances. States have responded by
re-scaling state power in the space of the doctor-patient consultation,
requiring in-person interaction and requiring the doctor-patient re-
lationship to involve components of surveillance and appraisal of
criminal activities. The surveillance of pregnant women and women
presenting with miscarriages or symptoms of pharmaceutical abortion
functions as yet another way that states can re-scale their power at the
level of the clinic or the pregnant woman, when medical advances
allow women to access abortion in autonomous ways that work outside
of state laws and medical infrastructure. Changing patterns of abortion
access develop through the contestation between pro- and anti-choice
actors for the control of abortion-related spaces at multiple scales.

Conclusion

A political geography of abortion calls for an alternative conception
of both abortion politics and political geography. Political geography
must contend with abortion (among other natalist policies) as a primary
site of state-making, where gendered power relations are enforced and
opposed. Feminist scholarship on abortion access must reconceptualize
it as a multi-scalar process of contestation and resistance that implicates
a variety of legal, medical, and social domains, rather than as a right
permitted or denied by the nation-state. Such a reconceptualization is
needed because abortion’s geography is currently undergoing a rapid
transformation through the increased availability of abortion pills.
While abortion is generally governed by a spatial logic of medical su-
pervision and criminalization that restricts access in practice, medica-
tion abortion pills rupture this spatial arrangement by allowing for
autonomous abortions in unsanctioned, non-clinic spaces facilitated by
transnational networks. As a break with existing modes of spatial or-
ganization, it is evident that non-clinic abortion presents a challenge to
traditional forms of regulation and meets with varying levels of state
intervention to re-assert control over abortion, whether in an attempt to
eradicate it from a territory entirely or to re-position it under state-
sanctioned medical supervision.

This paper offers a political geography of abortion that accounts for
some of the most important consequences of abortion’s spatial trans-
formation, but there is much more to be done. In concluding, it suggests
three future directions for the study of transnational reproductive
freedoms. As a starting point, we require a geographically informed
account of how different states respond to flows of abortion pills and
abortion travellers, because each political context is shaped by distinct
geopolitical relationships, border regimes, diaspora communities,
supra-national governance arrangements, and physical infrastructure
for cross-border mobility by people and medical technologies. Each of
these factors has major consequences for the abortion geographies that
arise there. By extension, the impact of growing abortion pill flows
raises the question of legal reform: the proliferation of abortion pills
evidently undermines existing abortion restrictions, but we require
more research to understand whether and where this provokes liber-
alization or further criminalization.

The next step for research in this area is to think beyond the law:
although legal reform is a goal for pro-choice pill networks, it is only an
intermediate step on the path to full decriminalization and demedica-
lization of abortion. A long-standing feminist reproductive health ethos
on autonomy through self-managed care and knowledge sharing (see
Murphy, 2012) animates much of the movement and inspires its vision
of the future for reproductive freedom. As restrictive laws have forced
the creation of clandestine abortion pill networks, pro-choice feminist
networks have come to the realisation that women who undertake self-
managed abortion often experience more control over their experience
than do women who access abortion through the formal healthcare
system (Jelinska and Yanow, 2018, p.2). The forces transforming
abortion access will continue to destabilize the political and medical
frameworks that attempt to contain it. Extant models for legal abortion
provision will also be transformed by the emergence of medication

abortion, as the recent regulatory changes in England and Canada de-
monstrate: self-managed care outside of a clinical setting is not only a
stopgap measure for women in states with highly restrictive laws.

Further research in this area should examine the technologies that
facilitate transnational abortion geographies, thinking outside of ex-
isting literature on fertility tourism and reproductive economies.
Because much of the cross-border knowledge transmission on medica-
tion abortion takes place over the phone and internet, changing abor-
tion geographies are increasingly bound up with other digital flows.
This means that the governance of abortion implicates the emergent
economies in digital and crypto-currencies, data privacy and online
security issues, state-led efforts at internet censorship, geo-fencing
technologies, and ‘dark web’ drug markets. Research on these digital
economies and technologies largely ignores abortion as a relevant site
for study, but the present and future of abortion access makes use of a
range of digital infrastructures to circulate information and material.
Transformative advances in abortion access will be determined by po-
litical struggles about the cross-border regulation of information,
technology, and mobility, rather than by further advances in re-
productive medicine.

Declaration of conflict of interest

None.

Acknowledgements

I am very grateful to Louise Amoore, Kath Browne, Fiona de
Londras, Cordelia Freeman and Francesca Moore for their thoughtful
comments on earlier drafts of this article. All remaining errors are my
own. The research for this article was supported by a Leverhulme Early
Career Fellowship (ECF-2017-698).

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Towards a political geography of abortion

States, clinics and reproductive space
Re-scaling abortion access
Mobile and digital clinics
Telemedicine and medical surveillance
Conclusion
Declaration of conflict of interest
Acknowledgements
References

O R I G I N A L A R T I C L E

Ectogenesis, abortion and a right to the death of the fetus

Joona Räsänen

Correspondence

Joona Räsänen.

Email: joona.rasanen@iki.fi

Abstract
Many people believe that the abortion debate will end when at some point in the future it will be

possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would

make possible to reconcile pro-life and pro-choice positions. That is because it is commonly

believed that there is no right to the death of the fetus if it can be detached alive and gestated in

an artificial womb. Recently Eric Mathison and Jeremy Davis defended this position, by arguing

against three common arguments for a right to the death of the fetus. I claim that their arguments

are mistaken. I argue that there is a right to the death of the fetus because gestating a fetus in an

artificial womb when genetic parents refuse it violates their rights not to become a biological parent,

their rights to genetic privacy and their property rights. The right to the death of the fetus, however,

is not a woman’s right but genetic parents’ collective right which only can be used

together.

K E Y W O R D S

abortion, ectogenesis, genetic privacy, parenthood, property right, right not to become a parent

1 | INTRODUCTION

The most prominent advocates of abortion rights believe that there is a

right to terminate a pregnancy but not

a right

to the death of the fetus.

Peter Singer and Deane Wills phrase this in the following way: ‘Freedom to

choose what is to happen to one’s body is one thing; freedom to insist on

the death of a being that is capable of living outside one’s body is another.’1

Judith Jarvis Thomson2 believes this, and so do David Boonin3, Frances M.

Kamm4 and Mary Ann Warren.5 More recently Bertha Alvarez Manninen6

and Lindsey Porter7 have reached similar conclusions.

Whether there is a right to the death of the fetus, in addition to

the detachment, is not a question not explored in detail before. Michael

Hawking argued – using an interesting thought experiment, viable vio-

linist – that the Thomsonian defence of abortion gives the woman only

a right to detachment, not a right to end the life of the fetus once it

has reached the point of viability.8 Recently Eric Mathison and Jeremy

Davis considered in this journal whether there is a right to the death of

the fetus when ectogenesis is available.9 They concluded that there is

no such right. Therefore, the possibility of ectogenesis should end the

abortion debate to all these people.10 That is because it would then be

possible to reconcile (alleged) fetal rights with women’s

rights.

1Singer, P. & Wells, D. (1984). The reproduction revolution: New ways of

making babies (p. 135). Oxford: Oxford University Press.
2Thomson, J. J. (1971). A defense of abortion. Philosophy & Public Affairs, 1,

47–66.
3Boonin, D. (2003). A defense of abortion (p. 257). Cambridge, UK:

Cambridge University Press.
4Kamm, F. M. (1992). Creation and abortion: A study in moral and legal

philosophy (p. 81). Oxford, UK: Oxford University Press.
5Warren, M. A. (1982). Postscript on infanticide, February 26, 1982. In J.

Feinberg (Ed.), The Problem of Abortion (pp. 116–119). Wadsworth, Belmont
CA; Warren, M. A. (2010). The moral difference between infanticide and

abortion: A response to Robert Card. Bioethics, 14, 352–359.
6Manninen, B. A. (2013). Yes, the baby should live: A pro-choice response

to Giubilini and Minerva. Journal of Medical Ethics, 39, 330–335.
7Porter, L. (2013). Abortion, infanticide and moral context. Journal of

Medical Ethics, 39, 350–352.

8Hawking, M. (2015). Viable violinist. Bioethics, 30, 312–316.
9Mathison, E. & Davis, J. (2017). Is there a right to the death of the foetus?

Bioethics, 31, 313–320.
10I use the term ectogenesis as it is commonly used in bioethical literature.

Ectogenesis refers the use of artificial or mechanical wombs. Ectogenesis

could be understood as an alternative to the whole gestation process where

the embryo is never inside a woman’s uterus. Here the focus is on a form
of ectogenesis which is sometimes referred to as an ectogenesis abortion

or partial ectogenesis, where the fetus removed from the woman’s uterus
alive will be gestated in an artificial womb. Although the technology is not

yet possible, the ethical issues of ectogenesis deserve careful philosophical

attention. For the sake of argument, I assume that a fetus (or technically a

blastocyst) would become a candidate for ectogenesis soon after it has

implanted in the womb.

Bioethics. 2017;31:697–702. wileyonlinelibrary.com/journal/bioe VC 2017 John Wiley & Sons Ltd | 697

Received: 6 March 2017 | Revised: 10 July 2017 | Accepted: 13 August 2017
DOI: 10.1111/bioe.12404

bs_bs_banner

http://orcid.org/0000-0002-7383-6138

I disagree. I argue that there is a right to the death of the fetus, but

that right is not a woman’s right. A right to the death of the fetus is a

right of the genetic parents and only together can they use this right. I

also consider what should be done when biological parents disagree

upon the fate of a fetus.11

Mathison and Davis considered three arguments why a woman

might have a right to the death of the fetus: 1) a right not to become a

biological parent 2) a right to one’s genetic privacy and 3) a right to

property. They argue that none of the arguments succeed. I believe

Mathison and Davis’ argumentation does not show that there is no

right to the death of the fetus. I consider their argumentation sequen-

tially and argue why there is a right to the death of the fetus. I claim –

contrary to Mathison and Davis – that because people have a right not

to become biological parents, a right to genetic privacy and a right to

their property and because ectogenesis without the consent of the

genetic parents of the fetus violates these rights, genetic parents have

a right to the death of the fetus.

I do not consider here whether the fetus itself has a moral standing

or whether it has a right to life, although I admit – and agree with

Mathison and Davis here – that to settle the issue fully, that is some-

thing which should be done.12 At the end of the article, I make some

remarks about the practical implications of my position and raise some

new questions to explore.

2 | THE RIGHT NOT TO BECOME A
BIOLOGICAL PARENT

An argument given in support of the right to the death of the fetus is

the right not to become a biological parent. Mathison and Davis (here-

after referred to as M&D) call this the ‘biological parents’ rights’ argu-

ment. Here, I frame the argument in detail and defend it against their

criticism. M&D state that spelling this argument out in more detail –

and perhaps the most common way, they say – is to argue that a right

to the death of the fetus is necessary for preventing certain harms

from befalling the biological parents. So, on this view, an abortion con-

sists of both terminating a pregnancy and preventing parenthood.

The harms in question are parental obligations which are linked to the

concept of attributional parenthood. That is the social attitude in which

others treat a genetic parent as though she still has the same moral obliga-

tions to the child as a custodial parent, even when the legal system has

absolved her of such obligations.13 Catriona Mackenzie explains this by

stating: ‘abortion is not a matter of wanting to kill this particular being,

which is, after all, as yet indistinguishable from oneself. It is rather a matter

of not wanting there to be a future child, so intimately related to oneself,

for which one either has to take responsibility or give up to another.’14

The insight of attributional parenthood leads to the Right Not to

Become a Biological Parent Argument:15

1. Becoming a biological parent causes harm to the couple because

of parental obligations towards the child.

2. The couple has the interest to avoid the harm of parental

obligations.

3. Therefore, the couple has a right to the death of the fetus to avoid

the harm of parental obligations.

M&D understand parental obligations in a way that the parents would

still feel morally responsible for the child, which then could cause them

significant psychological harm. They claim that such harm may be self-

or socially imposed. For example, others might discriminate the parents

by displaying negative attitudes or behaviour towards them. To support

this interpretation of parental obligations, M&D cite a study where sev-

eral women reported that ectogenesis would leave them with the lin-

gering sense of obligation towards the child, even if no legal obligation

were maintained.16

M&D reject the above argument. They admit that parents have a

right not to be discriminated against on the basis of attributional

parenthood, but they reject the argument by parity of reasoning. Put

another way, they claim that if the right not to become a biological par-

ent argument is sound, it leads to conclusions that are difficult to

accept (or at least which people do not currently accept). They claim

that:

[I]t does not follow from the fact that this treatment

[discrimination on the basis of attributional parenthood]

is wrong that one therefore possesses a right to the

death of the foetus. Indeed, there are reasons to doubt

that any such further right exists. To see why, consider

cases that look very similar to the one in question. Sur-

rogate mothers, egg and sperm donors, and women or

couples who give their child up for adoption may all

experience the harms of attributional parenthood, as

well as other felt obligations more generally. If the right

against the harms of attributional parenthood entail fur-

ther rights to prevent or avoid such harms in the case

we have been considering, they should entail similar

rights in these cases as well. And yet, in these other

cases, we do not typically think that the existence of

such harms gives rise to any further rights to the biolog-

ical mother or father.17

M&D seem to believe that the alleged intuitions against the claim

that gamete donors and surrogate mothers have rights towards the

child are a sufficient reason to believe that there are no such rights,

11In this article, I use the terms genetic parent and biological parent as

synonyms.
12Mathison and Davis also do not consider whether a fetus has a right to

life.
13Cohen, I. G. (2008). The right not to be a genetic parent. Southern

California Law Review, 81, 1115–1196.
14Mackenzie, C. (1992). Abortion and embodiment. Australasian Journal of

Philosophy, 70, 136–155. p. 152. Emphasis original.

15The formulation of the argument is my own, although M&D argue against

a similar argument.
16Cannold, L. (1995). Women, ectogenesis, and ethical theory. Journal of

Applied Philosophy, 12, 55–64.
17Mathison & Davis, op. cit. note 9, p. 315.

698 | bs_bs_banner R€AS€ANEN

and thus surrogate motherhood, gamete donation and adoption are

problem free practices. However, they omit the work of numerous phi-

losophers who argue, for example, that gamete donors do have parental

obligations (and perhaps rights) towards the child produced from their

gametes. Indeed, several scholars argue that no parental responsibility

theory can explain why the accidental father, who procreates due to

birth-control failure, has parental obligations towards the child but a

sperm donor does not. This notion has been brought forth by Rivka

Weinberg,18 as well as J.L Nelson,19 David Benatar,20 Melissa

Moschella,21 Reuven Brandt22 and Andrew Botterell23 – just to men-

tion a few.

It is also argued that mothers and fathers remain obliged, life-long,

to their birth children even when the child is adopted out. Lindsey Por-

ter frames this in the following way: ‘makers – that is, “birth parents”

and other causers – do not and cannot cease to be obliged to their

birth children, even when adoption takes place.’24

If these authors are correct, there is reason to believe that the

genetic parents have a right to the death of the fetus so that they could

avoid the obligations and harm of attributed parenthood. Adoption

won’t resolve the issue because parental obligations cannot fully be

transferred or delegated to someone else; such obligations are non-

transferrable in nature.

These claims might be against someone’s intuitions, but the intu-

itions alone are not a sufficient reason to believe that genetic ties, or

the fact that the parents have caused their child to exist, do not matter

in the case of gamete donation, surrogate motherhood and – ectogene-

sis abortion. Appealing to alleged intuitions is a somewhat common

way to argue in applied ethics, but without a proper theory that

explains why those intuitions are justified, the parity of reasoning argu-

ment fails. If one wants to reject the right not to become a biological

parent argument, one should offer a parental responsibility theory that

exonerates genetic parents from their parental obligations altogether

or give another reason why the argument fails. M&D do neither.

Because there are no alternative ways to avoid the harms of parental

obligations than the death of the fetus, the right to the death of the

fetus argument stands.

Some pro-choice philosophers have argued that abortion rights

include a right to the death of the fetus. Christine Overall, who has

recently changed her views about the right to the death of the fetus,

now states:

[W]omen who seek pregnancy termination are usually

choosing that there be no being at all who is their

genetic offspring. They are choosing not only not to be

social mothers, but also not to be biological mothers. In

other words, they are claiming a right not to reproduce.

(. . .) When women obtain a termination of pregnancy,

they are (. . .) acting upon their legitimate reproductive

right not to become a biological parent.25

I believe Overall is right when she claims that there is a legitimate

right not to become a biological parent. But she misses an important

point: procreation is a collective act involving two people, therefore the

biological father also has a right not to become a biological parent. The

fetus is not her project, as Overall claims, it is their project. Ergo, when

it is possible to gestate the fetus outside the womb, the fate of the

fetus is not her decision, but their decision.

3 | THE RIGHT TO GENETIC PRIVACY

Another way to argue for the right to the death of the fetus is to

claim that gestating the fetus, even if outside the womb, violates some

other rights the genetic parents possess. I believe ectogenesis abortion

violates two kinds of rights, in addition to a right of not becoming a

biological parent: a right to genetic privacy and a right to property.

There is at least in some cases a right to genetic privacy. For exam-

ple, if a mad scientist finds a way to clone humans, steals my DNA and

creates a fetus that is genetically identical to me, which he then ges-

tates in an artificial womb, my right to genetic privacy is violated.

Therefore, in such a case, I have a right to the death of the fetus.

Similarly, if ectogenesis abortions become reality, some women

(and men) will have genetic children out there who carry their genetic

material without their consent. In this scenario, their right to genetic

privacy has been violated, and the only way to avoid this is if they have

a right to the death of the fetus. Call this the Right to Genetic Privacy

Argument:26

1. People have a right to genetic privacy.

2. Ectogenesis abortion violates the genetic privacy of the genetic

parents of the fetus.

3. Therefore, genetic parents have a right to the death of the fetus.

I believe the mad scientist example shows that the first premise is true.

People in general have a right to genetic privacy. But does ectogenesis

abortion violate parents’ genetic privacy and if so, do genetic parents

18Weinberg, R. (2008). The moral complexity of sperm donation. Bioethics,

22, 166–178.
19Nelson, J.L. (1991). Parental obligations and the ethics of surrogacy: A

causal perspective. Public Affairs Quarterly, 5, 49–61.
20Benatar, D. (1999). The unbearable lightness of bringing into being.

Journal of Applied Philosophy, 16, 173–180.
21Moschella, M. (2014). Rethinking the moral permissibility of gamete

donation. Theoretical Medicine and Bioethics, 35, 421–440.
22Brandt, R. (2016). The transfer and delegation of responsibilities for

genetic offspring in gamete provision. Journal of Applied Philosophy, 33(4)

doi:10.1111/japp.12251
23Botterell, A. (2016). Why gametes are not like enriched uranium. Bioethics,

30, 741–750.
24Porter, L. (2012). Adoption is not abortion-lite. Journal of Applied Philoso-

phy, 29, 63–78.

25Overall, C. (2015). Rethinking abortion, ectogenesis, and fetal death.

Journal of Social Philosophy, 46, 126–140, p. 131. Emphasis original.
26Again, the formulation of the argument is my own, although M&D argue

against this argument.

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have a right to the death of the fetus? M&D are sceptical. They state

that even if there is a right to genetic privacy there will be considerable

limits to that right. M&D claim that at most, one has a right that her

entire genome not be released without her consent. But they don’t

argue why there is only a right that one’s entire genome not be released

– clearly more is needed than a mere declaration. M&D claim that

because the fetus’ genetic material comes only partly from the genetic

mother, the mother’s genetic privacy is not violated, in such a way that

she has a right to the death of the fetus. However, this line of reason-

ing explains only why the genetic mother has no right to the death of

the fetus. But the nature of this right has been misunderstood here.

A right to genetic privacy in the case of ectogenesis should not be

understood not as an individual but as a collective right. That is because

reproduction is not an individual but a collective action. Even though a

fetus shares 50% of its genetic material with each genetic parent

respectively, 100% of the fetus’ genetic material comes from its genetic

parents. Because having a genetic child in the world who carries the

genetic material of the parents without their consent is against their

right to genetic privacy, the genetic parents together have a right to

the death of the fetus. To use that right, however, they must be unani-

mous about it. Only if they both agree and want the death of the fetus

can they choose it to happen.

To conclude, a right to the death of the fetus is not an individual

right (as a right to terminate the pregnancy is), but a couple’s collective

right, therefore the right to genetic privacy argument stands. A right to

the death of the fetus is a right the genetic parents can only use

together.

4 | THE RIGHT TO PROPERTY

There is yet another way to claim that the genetic parents have a right

to the death of the fetus: the genetic parents own the fetus, and

because of that, their property rights are violated if the fetus is

gestated in an artificial womb without their consent. Call this the Right

to Property Argument:27

1. The fetus is property of the genetic parents.

2. People can destroy their property.

3. Therefore, genetic parents can destroy their fetus.

Common intuition seems to support both premises and therefore the

Right to Property Argument. For example, it is commonly believed that

the couple owns their (early) fetus or their embryos.28 Consider a cou-

ple who uses IVF treatment (in vitro fertilization) to get pregnant. Sur-

plus cryopreserved embryos are their embryos and no-one can use

them against the couple’s consent. In fact, it is commonly believed that

a couple using IVF has a right to destroy surplus cryopreserved

embryos. M&D share this intuition (and so do I).

Many people have inconsistent intuitions, as they believe it is

impermissible to kill the early fetus but permissible to destroy frozen

embryos. In both cases, there is an embryo involved that has a poten-

tial to develop into a fetus and then into an infant. The location of the

embryo is morally irrelevant so whichever position one holds, consis-

tency demands that the cases are treated the same, M&D claim. M&D

reject the claim that it is permissible to destroy cryopreserved embryos

and I reject the claim that it is impermissible to kill the fetus.

However, there is a way to make a moral distinction between cry-

opreserved embryos and early fetuses located inside a woman’s body.

One might claim, as Dale Jacquette does, that there are two kinds of

potentialities in question: naturally probable potentiality and merely

logically possible potentiality, and that only the former potentiality is

morally relevant.29 In the case of naturally probable potentiality, such

as what a fetus in a fully functioning womb has, the fetus’s develop-

ment into an infant is something we expect to happen, as long as there

is no fatal accident or interference involved. On the other hand, in the

case of merely logical possible potentiality, such as what cryopreserved

embryos would have, without outside interference these embryos do

not develop into anything. Although this distinction does not seem to

have implications for the ectogenesis debate, because a fetus has the

same kind of potentiality whether it is inside an artificial or a natural

womb, it does enable M&D to retain their intuitions regarding the

destruction of cryopreserved embryos while maintaining their position

about the death of the fetus. That is because a fetus located in a womb

has naturally probable potential for development, while a cryopre-

served embryo only has logically possible potential for it.

It is also commonly believed that people have a right to destroy

their property. As M&D state: ‘If we buy a rare piece of art, and sup-

posing that art can possess intrinsic value, we, as the owners, still

have the right to destroy it.’30 So why would there be no right to

destroy the fetus or the embryos? M&D argue that because even if

one owns something, there are limitations to what one can do to it.

They claim:

[C]ulturally protected buildings or artefacts can be pri-

vately owned but have use limitations. Buying a historic

building means we can occupy it, but we are not

allowed to raze it. (. . .) These limitations [to destroy] are

justified by appealing to the intrinsic value of the prop-

erty, or minimally the instrumental value the property

possess for those other than the owner.31

But why do I have a right to destroy a rare piece of art, as M&D

claim, but no right to destroy a historic building? They don’t give

any justification to why it would be permissible for the owner to27Again, the formulation of the argument is my own, although M&D argue
against similar argument.
28Although it is not a philosophical argument, it is worth mentioning that in

November 2016 a Missouri court has ruled that a divorced couple’s frozen
embryos should be treated as marital property. Retrieved from http://www.

bionews.org.uk/page_729067.asp

29Jacquette, D. (2001). Two kinds of potentiality: A critique of McGinn on

the ethics of abortion. Journal of Applied Philosophy, 18, 79–86.
30Mathison & Davis, op. cit. note 9, p. 318.
31Ibid: 318.

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destroy a rare piece of art but not a historic building – after all, they

both have intrinsic value and/or value to others. Perhaps M&D just

want to say that it is usually permissible to destroy one’s own prop-

erty but not always. So, is it permissible to destroy the fetus or the

embryos?

M&D think that because a fetus (and cryopreserved embryos)

shares only 50% of its genetic material with one individual, that individ-

ual cannot have a property right to it, and therefore has no right to

destroy it. But that is not a problem unless we want to claim that the

mother (or the father) alone has a right to the death of the fetus. That

is not the position I am arguing for. I claim that the fetus is collective

property of its genetic parents. When the genetic parents agree and

they both want the death of the fetus or the destruction of the

embryos, it is morally permissible for them to do so since they together

share 100% of the fetus’ or the embryos’ genetic material, and

gestating the fetus or the embryos against their consent violates their

rights.

Another reason why someone might reject the property right argu-

ment is that because many people are involved in the process of creat-

ing the embryos, it cannot be explained why only the parents own the

embryo. For example, M&D claim that in the process of in vitro fertil-

ization there are several people, most obviously, the doctor who

extracts the ova and performs the procedure – yet they do not have a

property right over the embryo. Therefore, we should reject this ver-

sion of the argument what M&D call the labour-mixing argument for

the property rights.

There are two responses I want to make here. First, as stated ear-

lier, many philosophers believe genetic ties are morally meaningful. If

they are right, that is a sufficient reason to believe that genetic parents

– and not the other parties – have a property right to the fetus and the

embryos. Because the doctor performing the IVF do not share genetic

material with them, he has no property right to the embryos – even

though he has taking a part of the process of creating the embryos.

Second, the objection against the labour-mixing argument for

property rights can be applied only to embryos created in the process

of IVF – not to a fetus created in normal sexual intercourse. When two

people have sex and it leads to fertilization, the two people are the

only ones bringing the fetus into existence by mixing their labour. So,

the labour-mixing argument for property rights explains why genetic

parents have property right to the fetus and why they do not have

property right to cryopreserved embryos.

Perhaps someone would object. For example, M&D argue that

because parents do not own their children, parents cannot own

their fetuses or embryos either. ‘If the justification for property is

that one has mixed one’s labour, then nothing about leaving the

womb explains why the baby is no longer the property of the

mother.’32 Obviously, children are not parents’ property. But that

has nothing to do with mixing labour. Children are not property

because children are persons: morally valuable individuals. Now,

whether a fetus is a person is a question outside the scope of this

article, although I admit that if an early fetus is a person, it might

change the outcome of the debate.33

5 | WHEN BIOLOGICAL PARENTS
DISAGREE UPON THE FATE OF THE FETUS

I have argued that biological parents have a right to the death of the

fetus. But an obvious question then rises: what should be done to the

fetus when ectogenesis is available and the biological parents disagree

regarding the fate of their fetus. There are reasons to believe that the

fetus can be killed or let die only when both parents consent to it.

First, when a man and woman are having sex, they implicitly accept

the possible consequences of their activity. As Rivka Weinberg states: ‘If

we do things that put our gametes at risk of joining with others and grow-

ing into persons, we assume the costs (and rewards) of that risky activity.’34

Because for the conception to happen, there needs to be two persons per-

forming the action (intercourse), it is those two persons that together have

responsibilities for the consequences. A right to the death of the fetus,

therefore, and for the reasons mentioned earlier, is a collective right.

Second, when only one person wants to use a collective right, he

or she cannot use that right. When Bob wants to marry Jane, but Jane

does not want to marry Bob, Bob cannot use his right to marriage,

because a right to marriage is a collective right and therefore cannot be

used alone.35 Similarly, when Bob wants the fetus to die, but Jane

wants it to live, Bob cannot use his right to the death of the fetus

because this right is not an individual but a collective right.

Third, in cases where genetic parents disagree, I believe we should fol-

low what can be called the status quo approach. According to this approach,

change needs a stronger justification than keeping things as they are.36

32Mathison & Davis, op. cit. note 9, p. 319.

33I am of course familiar with the wide scope of literature concerning the

moral status of the fetus. The most important defences of fetal rights and

the moral status of the fetus include: Marquis, D. (1989). Why abortion is

immoral. Journal of Philosophy, 86, 183–202; Lee, P. (2004). The pro-life
argument for substantial identity: A defense. Bioethics, 18, 249–263; Beck-
with, F. (2007). Defending life: A moral and legal case against abortion choice.

New York, NY: Cambridge University Press; George, R. P. & Tollefsen, C.

(2008). Embryo: A defense of human life. New York, NY: Doubleday; Kaczor,

C. (2015). The ethics of abortion: Women’s rights, human life, and the question
of justice (2nd edn.). New York, NY: Routledge. If these authors are correct

and killing a fetus is as wrong as killing any standard adult, then my argu-

ments might be refuted because a serious right to life could overweigh any

other rights the parents have. On the other hand, one might claim, if the

fetus has no value at all, so that killing the fetus is equivalent to, for exam-

ple, cutting one’s hair, then there would be no need to argue for the right
of the death of the fetus. So, perhaps my argumentation would convince

those who believe the fetus does not have full moral status equivalent to a

standard adult human, but who believe that the fetus is not akin to one’s
hair either. I think most people believe that a fetus has some but not a full

moral status, thus my argumentation should convince most people.
34Weinberg, R. (2015). The risk of a lifetime: How, when, and why procreation

may be permissible (p. 67). Oxford, UK: Oxford University Press.
35For defence of a right to marriage as a collective right see Williams, R. (2011).

Same-sex marriage and equality. Ethical Theory and Moral Practice, 14, 589–595.
36I cannot give a full defence of the status quo approach here but at least it

is intuitively compelling. Others have argued that humans prefer the status

quo approach so deeply that it is an irrational status quo bias. Bostrom, N.

& Ord, T. (2006). The reversal rest: Eliminating status quo bias in applied

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As long as there is no intervention to the pregnancy, the fetus will

naturally develop inside the woman’s womb. This means that there is

no change to the status quo and the fetus’ naturally probable potential

to develop into an infant would be actualized. Following the status quo

approach would mean that when one parent wants the death of the

fetus and the other does not, the fetus should not be killed or left to

die. Therefore, when, for example, a pregnant woman wants the fetus

to die, but the father wants it to live, the fetus should be detached and

implanted into an artificial womb where the fetus would continue its

development into an infant. Thus the status quo should be understood

from the point of view of the fetus: an already developing fetus would

continue its development in a womb – albeit an artificial one.

If the procedure of removing the fetus alive from the womb is

physically much more harmful to the woman than abortion, where the

result is the death of the fetus, she might have a right to choose the

latter. But at least when detaching the fetus alive is physically no more

harmful to the woman than abortion, she would be obligated to choose

ectogenesis abortion, the kind of abortion where the fetus detached

alive would be gestated in an artificial womb.

The status quo approach, together with a collective right to the

death of the fetus, would also mean that, for example, when an ex-wife

wants to gestate the cryopreserved embryos she and her ex-husband

have made, but the ex-husband refuses (as in Evans v UK), she cannot

gestate the embryos. But the ex-husband cannot have the embryos

destroyed either. This leads to what some might claim to be an odd con-

clusion: the embryos should be kept frozen indefinitely even though

they will never be used in any way. But until shown to be a totally unten-

able view, I am willing to accept that this is indeed what should be done.

What should be done when the biological father cannot be found

or the father is an anonymous sperm donor is beyond the scope of this

article. However, I am inclined to think that when the father is an anon-

ymous sperm donor he has already relinquished his demands regarding

the fate of the fetus. Therefore, the mother alone would have a right

to the death of the fetus.

6 | CONCLUSION

I have argued that genetic parents have a right to the death of the fetus.

That is because ectogenesis abortion without the consent of the genetic

parents violates their right not to become biological parents. It also viola-

tes their right to genetic privacy and their property rights. I have consid-

ered some recent objections against a right to the death of the fetus and

shown them to be flawed. I have claimed that Mathison and Davis omitted

important literature on how parental obligations are acquired and they

have not identified that a right to the death of the fetus is a collective –

rather than an individual – right. If my argumentation is correct, ectogene-

sis abortion will not solve the abortion debate since there will still be a

right to the death of the fetus. Therefore, we cannot reconcile pro-life and

pro-choice positions simply by gestating the fetus in an artificial womb.

I am not the first to argue that there is a right to the death of the fetus.

Stephen L. Ross37 has argued for it, as well as Catriona Mackenzie38 and

Christine Overall.39 However, my position differs from that of the aforemen-

tioned philosophers because I have claimed that the right to the death of the

fetus is not a genetic mother’s right but a couple’s collective right which they

can use only together. That right can also be used when the fetus is outside

a woman’s body – contrary to what Overall, for example, has argued. Of

course, nowadays a woman’s right to bodily autonomy outweighs other

arguments, but when ectogenesis becomes an option, this changes.

I have not argued that biological parents have a right to kill the fetus,

but that they have a right to the death of the fetus. Whether the fetus

should be left to die after the detachment but before putting it in an arti-

ficial womb, or whether it can be directly killed is for full discussion in

another paper. However, I am inclined to side with James Rachels that

there is no morally relevant difference between killing and letting die.40

My position has the value of equality because when ectogenesis

becomes possible, men and women can exercise equally their rights

not to become a genetic parent, their rights to genetic privacy and

property. Perhaps some feminists see this as a reason to object, but I

see it is a reason to value my position. As Tuija Takala suggests: ‘I sup-

pose the strong opposition to ectogenesis coming from many feminist

(sic) stems from the fact that it might increase the rights of males when

it comes to reproduction. But for anyone who is truly for equality this

should not be an unwelcome development.’41

ACKNOWLEDGEMENTS

I would like to thank Milla Miettinen for discussions on the subject

and her useful comments on earlier drafts of the manuscript. I also

thank two anonymous referees for their insightful comments on an

earlier version of the paper.

ORCID

Joona Räsänen http://orcid.org/0000-0002-7383-6138

AUTHOR BIOGRAPHY

JOONA RÄSÄNEN holds a Master’s degree in Social and Moral Philosophy

from University of Helsinki and a Master’s degree in Geography from

University of Oulu. He has research interests in applied philosophy and

bioethics, and he has previously published in this journal.

How to cite this article: Räsänen J. Ectogenesis, abortion and a

right to the death of the fetus. Bioethics. 2017;31:697–702.

https://doi.org/10.1111/bioe.12404

ethics. Ethics, 116, 656–679. Yet others have argued that it is rational to
keep things as they are. Nebel, J. M., 2015, Status quo bias, rationality, and

conservatism about value. Ethics, 125, 449–476.

37Ross, S.L. (1982). Abortion and the death of the fetus. Philosophy and

Public Affairs, 11, 232–245.
38Mackenzie, op. cit. note 14.
39Overall, op. cit. note 25.
40Rachels, J. (1975). Active and passive euthanasia. New England Journal of

Medicine, 292, 78–80.
41Takala, T. (2009). Human before sex? Ectogenesis as a way to equality. In

F. Simonstein (Ed.), Reprogen-ethics and the future of gender (pp. 187–195, p.
190.). Dordrecht: Springer.

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http://orcid.org/0000-0002-7383-6138

https://doi.org/10.1111/bioe.12404

If Abortion, then Infanticide

David B. Hershenov1 • Rose J. Hershenov2

� Springer Science+Business Media B.V. 2017

Abstract Our contention is that all of the major arguments for abortion are also
arguments for permitting infanticide. One cannot distinguish the fetus from the

infant in terms of a morally significant intrinsic property, nor are they morally

discernible in terms of standing in different relationships to others. The logic of our

position is that if such arguments justify abortion, then they also justify infanticide.

If we are right that infanticide is not justified, then such arguments will fail to justify

abortion. We respond to those philosophers who accept infanticide by putting forth

a novel account of how the mindless can be wronged which serves to distinguish

morally significant potential from morally irrelevant potential. This allows our

account to avoid the standard objection that many entities possess a potential for

personhood which we are intuitively under no obligation to further or protect.

Keywords Abortion � Infanticide � Potential � Harm � Moral status

Introduction

It is frequently claimed that there is no common ground between abortion defenders

and opponents. One side may believe that the existence of a divinely created soul

bestows value upon its possessor, or that mere membership in the human species

warrants special protection, or that fetuses are persons from conception and so forth,

& David B. Hershenov
dh25@buffalo.edu

Rose J. Hershenov

rhershenov@niagara.edu

1
Philosophy Department, University at Buffalo, 135 Park Hall, Buffalo, NY 14260, USA

2
Niagara University, 5795 Lewiston Road, Lewiston, NY 14109, USA

123

Theor Med Bioeth

DOI 10.1007/s11017-017-9419-7

http://crossmark.crossref.org/dialog/?doi=10.1007/s11017-017-9419-7&domain=pdf

while the other side denies these. The result is deadlock. Nonetheless, there is

common ground—virtually everyone on both sides of the debate is opposed to

infanticide. However, the unwelcome news for abortion defenders is that all of the

major defenses of abortion draw upon principles that also permit infanticide. It is

well-known that defenses of abortion based upon the grounds that the fetus is not a

(neo-Lockean) self-conscious person would allow infanticide as well. But though

less well known, infanticide would also be allowed by abortion defenses that rely on

Judith Thomson’s [1] appeal to a woman’s control of her body, Elizabeth Harman’s

[2] and David Boonin’s [3] reliance on the moral significance of consciousness,

Agnieszka Jaworska and Julia Tannenbaum’s [4] stress on the absence of a rearing

relationship, Elselijn Kingma’s [5] claim that the fetus is literally a part of the

mother, or the American Supreme Court’s resort to viability.

We contend that there is no way to distinguish an infant from a fetus in terms of

an intrinsic morally relevant feature that the former has and the latter lacks—neither

one is rational, morally responsible, self-conscious, concerned about the future, etc.

They both lack the cognitive abilities of most household pets. There have been

attempts to distinguish healthy fetuses from newborns, but they are no more

successful in securing considerable moral status for infants than pointing out that

rabbits and dogs differ in their mental abilities can bestow any significant moral

status upon the more mentally advanced dog. For instance, Jose Bermudez [6]

appeals to a minimal sense of self that newborns acquire through imitation. But the

sense of self in the newborn is far less than that possessed by the dog that misses its

departed owner and anxiously awaits his return, so it is surely too rudimentary to

matter morally. Likewise for Regina Rini’s point that when a fetus becomes

biologically independent of its mother, it has aims that it did not before as it

responds to needs for warmth and food and other needs by ‘‘playing the tiniest role

in their accomplishment through its grasping, suckling and crying…. [N]ewborn
infants have aims, but fetuses do not … if the vulnerability of such aims to
frustration is morally significant, then there is a morally relevant difference between

a fetus and a newborn’’ [7, p. 356].
1
Not only are these aims limited to healthy

infants, not to premature or ill infants, but they do not distinguish the infants’ moral

status from that of any household pet or backyard animal. Other philosophers like

Mary Anne Warren write of the bombardment of stimuli that distinguishes birth

from prenatal existence and that the birth of the infant ‘‘marks the beginning of the

infant’s existence as a socially responsive member of a human community’’ [8,

p. 62]. Not only is this not true for premature or ill newborns, but even if it did

distinguish the infant from the fetus, it could not justify any moral status of any

significance since countless non-human young have equivalent abilities but are

accorded little moral status in virtue of them.

That the newborn has not reached a stage of development that bestows intrinsic

value and warrants protection can be more clearly seen if one eliminates any subtle

influence of the potentiality of the infant on one’s thought by imagining another

1
Warren, in her paper on the moral significance of birth, provides counterexamples to Rini’s claims that

‘‘Newborn infants have aims but fetuses do not.’’ Warren points out that late term fetuses, like infants,

turn away from bright lights, respond to loud noises, voices, or others sounds, and are also responsive to

touch, taste, and motion [8, pp. 49–50].

D. B. Hershenov, R. J. Hershenov

123

species that normally develops mental states comparable to that of the human infant

but then naturally stagnates, i.e., stays alive but undergoes no further cognitive

development. Such creatures would have very little moral status and we would seem

to be obliged to do little, if anything, to save them, and would not have to take on

much more in the way of burdens to avoid killing them.
2

In addition to rejecting intrinsic bases for distinguishing infants and fetuses, we

will also show that it is unsatisfactory to attempt a distinction on an extrinsic basis,

for it is not always the case that infants can survive independently of their mother’s

bodily support, are less of a burden on their mothers than fetuses, or are in a morally

significant relationship that the fetus is not.

The logic of our position is that if the standard arguments for abortion justify the

practice, then they also justify infanticide. In this article, we will consider the

following five well-known arguments for abortion and show not only that they

justify infanticide but also that the principles they rely upon are not morally

compelling.
3
(1) The inequity of imposing burdens only upon women, but not men,

justifies a right to abort. (2) The fetus does not warrant protection until viable. (3)

The bodily burdens of pregnancy are too great to deny women an autonomy right to

abort throughout their entire pregnancy. (4) Non-sentient fetuses can be aborted

because they lack moral status prior to the onset of consciousness. (5) Fetuses are

parts of the mother, newborns are not. Following this critique, we will then help

ourselves to modus tollens and argue that since infanticide is widely rejected,

abortion should be as well.

Alas, we cannot today just assume that our readers will accept that infanticide is

beyond the pale.
4
Some readers will admit that we have shown that abortion and

infanticide are morally the same, but opt to permit both rather than prohibit both. So,

we will further argue that when potential is properly understood, abortion and

infanticide can be seen to be a considerable harm and evil. We contend that both the

defenders and critics of potentiality arguments in the abortion debate have failed to

appreciate that the potential of mindless or minimally minded creatures that matters

morally is their potential for healthy development. We argue that crucial for

understanding the moral significance of potentiality is the fact that mindless

organisms have interests but only in their healthy development. When they are

mindless, they are without interests in other potential futures. Unlike most kinds of

organisms that develop minds, the operations of a healthy human mind are of a

sophistication and range that bestows them with great value and enables their

possessors to obtain unrivaled levels of well-being. Thus, the frustration of those

interests in healthy mental development is a great harm. Since the healthy

development that is in the fetus’s interest can require all sorts of extrinsic

2
We assume killing is morally worse than letting die, and the evidence for that belief is that one must

take on more burdens to avoid killing someone than to allow an individual to die. For support, see Frances

Myrna Kamm [9].
3
We are not aware of any other principled defenses of abortion that do not also generalize to allow

infanticide. For example, just stipulating that birth bestows the moral status required for protection

against being killed does not provide a principled distinction between abortion and infanticide.
4
Alberto Giubilini and Francesca Minerva recently defended ‘‘after-birth abortion’’ [10]. Michael Too-

ley [11], Peter Singer [12], Jeff McMahan [13], and John Harris [14] earlier argued for infanticide.

If Abortion, then Infanticide
123

interventions, the morally relevant potential is not limited to that which is intrinsic,

active, normal, or probable. And given that those real or hypothesized non-human

beings who are supposed to show the absurdity of protecting potential are not

unhealthy if the mere possibility of their personhood is not actualized, then it

follows that they do not have any interests frustrated by that potential going

untapped. So, potentiality properly construed in terms of healthy development is not

susceptible to reductio ad absurdum, unlike understandings of potentiality as

metaphysical or physical possibility.

Ours is not the only theory to maintain that moral status does not depend upon

sophisticated mental faculties that have already been manifested. So, we finish with

a discussion revealing that our appeal to non-intrinsic developmental features is

successful where an appeal to person-rearing relationships of Jaworska and

Tannenbaum [4] is not. We also show that the latter, like all the other discussed

cutoff points alleged to permit early abortion but not the killing of more developed

human beings, would have to tolerate infanticide.

An abortion ban violates a woman’s right to equal treatment

Since only women get pregnant, they suffer unequally because of their biology. Men

are free from the physical burdens and dangers of pregnancy, as well as the loss of

employment, educational and social opportunities due to unwanted pregnancies, and

child raising. If women are not allowed to choose to be free from a pregnancy that

men naturally avoid, they will bear unequal burdens and be permanently relegated

to second class citizenship.
5
Therefore, some conclude that women are entitled to

abort unwanted pregnancies.

We suspect that few abortion defenders will, upon reflection, insist that abortion

is unjust because it involves an unequal distribution of burdens that falls only on

women. While it is true that only women can get pregnant and no comparable

burden is imposed upon men,
6
we suspect that equality is really beside the point.

This suspicion is partially based upon our belief that if men could also get pregnant

and consequently experienced equal limitations, those using this argument to defend

abortion would still endorse a right to abortion. Egalitarian abortion defenders

would not want abortion rights to go away if motherhood increases a woman’s

standing above that of men. Imagine that more respect and power came with more

children [16, p. 98]. Nor would they want abortion rights to vanish if men were

5
Variations of the equality defense can be found in Catherine McKinnon [15], Martha Nussbaum [16,

pp. 342–343], Melinda Roberts [17, pp. 162–164], Alison Jaggar [18, pp. 147–149], Cass Sunstein [19,

pp. 29–44], and Sally Markowtiz [20, pp. 12]. Even Thomson [21] expresses some sympathy for this

position, though she is better known for appealing to a bodily control defense [1].
6
Perhaps wars were once fought in such a physically demanding manner that the armies had to be

drafted from only the ranks of men. More likely, the nature of battle only required wars to be fought by

the conscription of men or women of sufficient strength. Perhaps then the physically strong were

disadvantaged by their biology but not wronged. However, the benefits and burdens of fighting may be

too disanalogous to child bearing to be used in an analogical argument.

D. B. Hershenov, R. J. Hershenov
123

legally required to take on more childcare burdens after birth so that the mothers did

not lose out on social-economic opportunities.

This inequality argument provides a defense of infanticide. If we modify a

Frances Myrna Kamm example, imagine that women so bond with their children

around a week after childbirth that they cannot give them up for adoption or let

anyone else provide for their day care. Our society surely would not let them

commit infanticide in the week before the unbreakable bonds set in. If such changed

desires are too farfetched, then imagine a woman giving birth in an isolated

community where there is not any digestible formula, breast pumps to fill up bottles,

available wet nurses, or other substitutes for her nursing. Thus, the mother must

breastfeed around the clock. Assume this is painful as well as exhausting, and limits

her social, educational, and professional opportunities more than it limits the

father’s opportunities. Nevertheless, the mother surely cannot kill or let die the

nursing child despite these considerable burdens being unequally distributed.
7

Whatever one thinks about the need for more equality, it is typically maintained

that one cannot kill to remove barriers to equality, especially when those killed are

not blameworthy. So, if inequality arguments do not justify infanticide, then why

would they justify abortion? We have already mentioned that there is not any

intrinsic morally significant difference between fetuses and newborns. The isolation

in the second infanticide thought experiment removes the typical extrinsic

difference between fetuses and infants: the burden of the infant being transferable

to others. The limits of the equality approach support our suspicion that avoiding

inequities is providing a reason to have an abortion that ultimately must be justified

independently from social inequalities.
8
So, if the inequality presently plays any role

here, it is just intensifying the existing grievance of having one’s bodily freedom

restricted in a society where women have historically been denied the opportunities

of men. We think that what is far more likely to be doing the real moral work in this

defense of abortion is a belief that a woman’s autonomy allows her to refuse to take

on the immense physical burdens involved in pregnancy, regardless of whether the

burdens are universally shared. Unequal treatment is really beside the point, for such

an exercise of autonomy would be deemed legitimate for men as well if they could

become pregnant or faced equal burdens and opportunities.
9

7
Any concerns that such unequal burdens are not considerable enough—thus, that infanticide is unjust

while abortion is not because nursing is not as difficult as carrying a fetus to term—will be met by our

response below to the fourth argument.
8
Our view is shared by Kamm [22, p. 98].

9
We should qualify our claim and recognize the case of Sally Markowitz, brought to our attention by an

anonymous referee, who would seem to accept the inequality defense of abortion even if that means

abortion could be banned in a truly egalitarian society. The conclusion of Markowitz’s 1990 article is,

‘‘Let feminists insist that the condition for refraining from having abortions is a sexually egalitarian

solution’’ [20, p. 12]. So, that remark and earlier comments that are somewhat dismissive of the autonomy

defense of abortion may indeed mean that Markowitz would prefer the equality justification to the

autonomy defense of abortion. Markowitz writes, ‘‘Autonomy arguments though are not much of an

improvement. They take into account the well-being of individual women but they manage to skirt the

issue of woman’s status, as a group, in a sexist society’’ [20, p. 3]. Nevertheless, we still suspect that most

of those who appeal to the equality defense will fall back on the autonomy defense given that it could

mean abortion rights would lose that justification in an egalitarian society.

If Abortion, then Infanticide
123

Abortion is permissible until the fetus becomes viable

We will first consider viability to mean that the fetal individual can live

independently of the gestational mother and then subsequently understand it to

mean that an individual can live independently of any particular person’s bodily

support or mechanical substitute for an immature or failing biology. On either

construal, if the principle of viability truly forms the basis of the abortion

defender’s position, then it will allow for infanticide. Consider a woman giving

birth in an isolated community where adoption services are absent or she is unable

to put the child up for adoption for months. Assume, as before, that there is no

alternative to around-the-clock breastfeeding because there is no formula available

or the baby cannot digest it. The infant is not viable because she cannot live

without being sustained by internal products of the mother’s body. If the reader

insists that the newborn who needs her mother to produce milk is just generically

dependent upon the mother’s body, unlike the gestating embryo whose needs

cannot be met by anyone else, then we can just stipulate that the mother’s milk is

unique and no wet nurse can be substituted. Surely the mother cannot legitimately

bring about the death of her dependent newborn even though the child is not

viable, i.e., cannot live without the support of the nourishment provided by her

body.
10

So, independence from one’s mother cannot be the basis of the moral

status that protects one’s life.

We can also easily show that viability is not a morally significant principle if the

term just means that one can live independently of the biological support of others,

not just the mother. Consider conjoined twins. There is not a lack of moral status if

one or both are unable to survive separation surgery and live independently of the

other. Or imagine someone’s failing body resulting in their needing medical

equipment to stay alive. Such people would not lose any moral status during the

time they lack viability.

We suspect that most of those who defend abortion by appeal to viability do not

really believe viability is morally significant. Their lack of a deep commitment to

the principle of viability can be revealed when they are asked to imagine

hypothetical scenarios where the timing of the onset of viability is changed.

Consider first a scenario in which viability does not occur until late in the ninth

month of pregnancy, though all other development continues normally. Abortion

would be permitted virtually up to birth. But few abortion proponents would be

comfortable with this, even though they should not be disconcerted if viability truly

mattered morally. Next, assume that the onset of viability occurs just a few days

after conception. Most women would discover they are pregnant after the embryo

becomes viable and thus virtually no abortions would be justified.
11

But if viability

is held to be a morally legitimate cut off point for abortion, then whenever it occurs,

10
If one objects that the mother would just be letting the child die by not feeding it, then imagine a

hungry infant aided by a relentless adult who continually places the newborn upon the woman’s breast.

The only way to stop such imposed feedings is to kill the infant.
11

To meet the objection that such women could still avoid the pregnancy by giving birth prematurely, we

stipulate that some pregnant women are too frail to safely induce labor, though they could safely abort.

D. B. Hershenov, R. J. Hershenov
123

that threshold should be morally acceptable.
12

But the discomfort with viability as a

cut-off point, if it were to occur much sooner or much later, suggests to us that what

really accounts for the appeal of viability is not the actual principle of total

independence from the mother but just the current time at which our existing

biotechnology enables the fetus to become capable of living outside the womb. We

surmise that the attraction of the current onset of viability at roughly six months

after conception is because it gives women a grace period to reflect upon such a

weighty decision and still allows abortion defenders to admit the nearly-born fetus

has some value and deserves a modicum of respect and protection without forcing a

woman to provide an unwanted nine months of bodily support.

Consciousness distinguishes abortion from infanticide

Some philosophers defend the position that consciousness is a morally significant

threshold that can distinguish earlier permissible abortions from later impermissible

abortions. Our response is that they are overestimating the importance of their own

thoughts—and everyone else’s. They need to explain why consciousness is

important for immunity from being killed.
13

Is it because the conscious person

would then undergo a painful death? It would seem not. An infant (or anyone) could

be painlessly killed while asleep, but surely that is wrong. Is it that consciousness

brings a morally significant cutoff point for permissible abortions because only the

conscious can have certain interests that warrant protection? Again, the answer

seems to be no. Consider a newborn unaware that she needs some high tech life-

saving procedure to avoid a painless disease and death. Surely, it is in the infant’s

interest to have her health maintained even though she is not conscious of that

interest.

The existence of interests that one is unaware of is what makes it so hard to

believe Harman’s claim that while mindless embryos have an interest in continued

life and are greatly harmed by their death, such interests do not have moral

significance since the embryos are not conscious [2, p. 185]. It is very difficult to see

why consciousness would make such harm a morally significant harm if the

conscious newborn is not conscious of its longstanding interest in its life being

preserved. So, if consciously conceptualizing that interest is not required for that

interest to belong to the infant and to matter morally, why would that interest not

exist earlier and be morally significant in the embryo before there is any

consciousness at all? Alternatively, if the mindless embryo is not protected from

abortion because it does not have an interest in more life in the absence of a

conscious concern with living on into the future, then it is difficult to see why the

12
Contrast viability with the onset of an obviously morally significant trait like having a mind like ours.

If a mutation resulted in such a mental life arising in the fetus before viability, many who previously

accepted abortion at that stage would find it nearly impossible to do so anymore. At best, they would have

to rely upon Thomson-like arguments that refer to features extrinsic to the fetus, such as it being an unjust

burden upon the unwilling

mother.

Harman surprisingly declares that she ‘‘will not offer any independent argument for’’ the claim that ‘‘a

being has moral status at t just in case it is ever conscious and it is not dead at t’’ [2, p. 184].

If Abortion, then Infanticide
123

fact that the infant is already conscious protects it against infanticide, if it has not

consciously entertained a concern with surviving into the future.

Boonin claims that the newborn should be accorded an idealized desire in staying

alive [3]. He argues that the newborn’s desires for warmth and food etc. gives her an

idealized desire to live so as to fulfill those conscious desires. He compares the

newborn’s desire for more life to the idealized desire of a hiker to go left at a fork

because he is unaware of a bomb planted on the path forking to the right. The hiker

has desires in avoiding injury, pain, etc. that would give her an idealized desire to

avoid the bomb on the right fork even though she is unaware of its presence. We

argue that Boonin’s account is insufficient because the newborn has interests that

cannot be explained by idealization. The newborn can have a non-conceptualized

interest in surgery that will ensure reproductive capacities or a certain kind of

intellectual growth that does not serve any of her present desires in warmth, food,

etc. We even hypothesize that the newborn can outgrow its existing desires but still

retain an interest in future life that it does not conceptualize. For example, the

interest in food is really just a desire to remove a feeling of discomfort, at least

before the first breastfeeding. We take perhaps some liberties, but harmless ones, to

make our point by imagining that the baby’s qualia and desire for the first liquid

meal is unlike the qualia and desire later for solids. The newborn surely has an

interest in living and a right to life that she cannot conceptualize which is not

captured by an idealization ensuring existing desires are satisfied. If not, infanticide

is acceptable. So if an infant has interests that she is unaware of that are not

idealizations from given existent desires, the same is true for the non-conscious

fetus.

It cannot be that the onset of consciousness by itself so increases a creature’s

value that it becomes wrong to kill it. There are countless types of nonhuman

animals that are conscious but have very little moral status. So consciousness per se

seems to bestow little value. It is really the potential for a certain type of

consciousness that matters morally. But Harman, perhaps influenced by Shelly Ka-

gan’s [23] discussion of the additive fallacy, is sympathetic to the idea that it is

consciousness and potentiality that together bestow moral significance. Kagan

diagnosed an additive fallacy where the reduction of value due to the removal of one

feature wrongly led to a belief that the value of the whole was to be determined by

adding the value of the components. An analogous mistake would be removing an

ingredient from a recipe that resulted in it tasting half as good as it did before and

thus thinking that the removed ingredient provided half of the good taste. If the meal

scored a six on a taste scale, the removed ingredient would then be ranked a three

according to the fallacious additive inference. But that ingredient may have been

rather bland by itself, so its contribution with other ingredients to the fine taste of the

meal is better captured by a multiplier than an additive effect.

However, we can show the unimportance of multiplying consciousness with

potentiality if we imagine a scarce life-saving drug that one can either give to a five-

month-old fetus that just became minimally conscious a day earlier or to a fetus that

will become minimally conscious in a day. Consciousness, in this case, seems to

hold little value; it appears to be a coin toss to decide who gets the drug. Such

reactions suggest that we are not guilty of an additive fallacy and overlooking how

D. B. Hershenov, R. J. Hershenov
123

potentiality and its partner properties produce value via multiplication. Such

responses to the scarce drug choice scenario perfectly cohere with our claim that it

is the potential for personhood of the embryo at any stage that matters rather than

the potential for personhood only of the conscious.

A perennial challenge for the abortion proponent is to defend abortion without

offering a justification of infanticide as well. Some abortion defenders argue that

consciousness is what provides moral status and what makes late abortion and

infanticide wrong, but not early abortion. It is standardly thought that consciousness

emerges around five months after conception. So, one feature that appeals to many

is that early fetuses can be killed but that consciousness protects the infant.

However, unhealthy newborns might lack consciousness such that infanticide is not

ruled out in their case. Perhaps some people will accept the killing of the mindless.

Even so, we doubt they would if the lack of infant consciousness was temporary.

But then it is hard to see why the temporary unconsciousness of the fetus fails to

protect it.

We suspect that most abortion defenders are, unbeknownst to themselves, not

really committed to the moral significance of consciousness. We will mention two

possibilities to support this. The first has to do with panpsychism and the second is

akin to our argument against viability that involved changing the onset of the

allegedly morally significant cutoff point. First, if panpsychism is true, then

consciousness or experience is not going to be a morally significant divide since

everything has some sort of experience. Panpsychism strikes us as a live possibility,

that is, for all we know, it is true.
14

The epistemic possibility of panpsychism suggests that the abortion cut off

position would then have to be reconstrued as a type of consciousness that brainless

embryos lack. This seems to be, morally, a less significant ontological divide.

Distinguishing those with experiences from those without has some plausibility as a

moral demarcation. Even making a moral distinction between those with self-

consciousness and those with mere consciousness seems somewhat plausible. But

distinguishing brainless experiences hypothesized by the panpsychic from mere

14
Galen Strawson claims that consciousness can no more arise from non-consciousness than the

extended from the non-extended, the spatial from the non-spatial, or the abstract from the concrete.

Strawson believes brute generation ‘‘is actually incoherent and that emergence has acquired an air of

plausibility (or at least possibility) for some simply because it has been appealed to many times in the face

of seeming mystery’’ [24, p. 12]. He contrasts the brute emergentist relation of the mental from the

physical with that of the liquidity from water molecules. The molecules of water have properties and obey

laws, so that liquidity can be seen to consist in nothing else but their lawful interactions. It is not at all

mysterious how their movement gives rise to liquidity. To put it in David Chalmers’s language [25], the

facts of liquidity are fully determined by the lower level physical facts, assuming one has the upper level

concept of liquidity. But the emergence of consciousness from the non-conscious physical is not like that.

And there is little hope that a future science will enable us to discover an entailment from the physical to

the experiential because future physics will just be more of the same structural and functional

explanations. We only know of the fundamental physical entities by their relations—i.e., how they affect

other objects. For example, what it is for something to have mass is to accelerate when encountering

certain forces and the like. But conscious experience is not functional. Any future physical functional

story of causal inputs and outputs could operate in the absence of experience, i.e., in Chalmers’s zombie

world. The problem is that conscious experience involves something it is to be like and this is not a

functional conception.

If Abortion, then Infanticide
123

consciousness of those fetuses and newborns with very limited brains seems less

significant metaphysically and morally. So the epistemic possibility of panpsychism

can help readers see that they are not really committed to the moral significance of

mere consciousness. They would not consider it wrong to destroy the many

brainless entities with minimal experiences in a panpsychic world.

A second reason to doubt those readers’ commitment to the moral significance of

consciousness is that the real moral ‘‘heavy lifting’’ may be being done by the timing

of the onset of consciousness rather than the mere presence of consciousness. Our

suspicion is that the emergence of a mind at five months is appealing because it

provides women with a grace period to make such momentous decisions. Banning

abortion from that point onward serves to recognize the value of the fetus. To ensure

that it is consciousness itself that is solely significant, we suggest altering the onset

of consciousness. Imagine the fetus becomes minimally conscious a week after

fertilization. If consciousness were a morally significant cut off point, then abortion

would be impermissible before most women even knew they were pregnant. Most

pro-choice advocates would not find that an appealing cut off. Next, imagine fetuses

do not become conscious until late in the ninth month of pregnancy, just days before

birth. Would abortion be acceptable nearly right up to delivery? We very much

doubt it.

A right to be free of considerable bodily burdens

We believe that the autonomy right to control one’s body is the most common

defense of abortion and probably what is really doing all of the justificatory work for

those who appeal to the first and third of the above arguments, and doing much of

the moral heavy lifting in the case of viability.
15

More precisely, this right to control

one’s body is the right only to reject immense burdens since many abortion

defenders believe that late abortion can be banned and thus a woman compelled to

use her body to support another for a few months. In Thomson’s language, the right

would only entitle women to refrain from being a Good Samaritan for ‘‘there may

well be cases in which carrying the child to term requires only Minimally Decent

Samaritanism of the mother, and this is a standard we must not fall below’’ [1,

p. 65]. However, our contention is that if there is such a right that justifies abortion,

then it will also justify infanticide.

Imagine a tornado throws a newborn (a potential person in the Neo-Lockean

conception of ‘‘person’’) and an unrelated adult onto the roof of an extremely

damaged building. The newborn is on that adult’s lap and wiggling. Her wiggling

will cause the roof to collapse and both the adult and newborn to fall. If the newborn

had remained still, both would have been fine. Given the adult’s current position, he

will hit the ground first and will thus cushion the infant who will emerge unscathed.

The position the adult is in when he hits the ground will make the impact as painful

as an actual delivery that ends a pregnancy. In addition, it will cause him nine

15
The current technologically dependent onset of viability means a woman’s body can at most be used

for about three months against her wishes.

D. B. Hershenov, R. J. Hershenov
123

months of back pain, abdominal swelling, nausea, frequent urination and bodily

discomfort comparable to that endured in a pregnancy. If he rotates before the roof

gives way, then he will cause the child to hit the ground first and the impact will

fatally crush his skull but the adult will be able to land on his feet and walk away

unharmed.

Is the adult morally permitted to rotate and kill the infant to avoid nine months of

physical pain? It would seem not. And that is true even though the newborn has no

right to be on the adult’s body
16

and his wiggling will be the cause of his burdens

just as the fetus is a hardship for the pregnant woman. Why then would the mother’s

right to control her body justify killing a fetus, which, like the infant, is just a

potential person? We noted in the introduction that there is not a morally relevant

(intrinsic) developmental difference between fetuses and infants. And we have just

shown that they cannot be distinguished morally on the (extrinsic) basis of fetuses

being more burdensome than infants.

Why then is the intuition in Thomson’s violinist scenario that the kidnapped

reader can disconnect and bring about the death of the violinist? Drawing upon Peter

Unger’s work, we would venture that the psychologically efficacious factors

determining our divergent responses in the two thought experiments are those he

calls ‘‘projective separation’’ and ‘‘projective grouping’’ [26, pp. 96–101]. The

psychological phenomenon of projective grouping is illustrated in our rooftop case.

The two individuals, neither of whom are responsible for his or the other’s

predicament, are both understood by the reader to be in the same bad situation

facing a threat. Our psychological makeup is such that we projectively group the

entangled people together in the same unfortunate scenario, and then, once we view

their plights as interconnected, we feel compelled to minimize the harm in such a

scenario, and this amounts to letting the larger person shield the smaller.

Projective separation can be illustrated by Thomson’s famous thought experi-

ment. The healthy person and the violinist who ends up supported by him are not

viewed as being in the same bad situation. The ailing violinist is understood as

having his harm ‘‘transferred’’ to a completely unrelated person.
17

The healthy

person in the violinist scenario is not like the larger person entangled in the ropes.

Instead, the healthy person is viewed as an uninvolved person, whose relationship

with the violinist begins only after the latter becomes ill and even then is

accomplished through a kidnapping which in our minds serves to highlight the

distance that existed between the two men. In Unger’s language, we do not

projectively group him with the violinist in the same bad situation, instead we

projectively separate him from the violinist. Because of this projective separation it

16
Someone lacking a right to be on or in one’s body means they can be removed even if they do not want

to be. But they can be removed only if that can be done safely. To better appreciate this, imagine that

someone who is bird watching and absent mindedly trespassing on one’s private property trips and breaks

his neck. That person has no right to remain there. But if moving the person would be fatal, then his right

to life permits him to stay where he otherwise does not have a right to be. So, our position about the

wrongness of abortion and infanticide can be maintained even if we admit that the fetus has no right to be

in someone’s body and the newborn has no right to be on it.
17

Patrick Lee speculates that it may also be that the violinist is tainted by the kidnappers and so is

experienced as inheriting some of their evil [27, p. 127].

If Abortion, then Infanticide
123

appears wrong for the violinist’s misfortune to be transferred to the man with the

healthy kidney.
18

Thomson’s Henry Fonda case can be seen as further evidence for our Unger-

inspired thesis about the morally irrelevant but psychologically efficacious

projective grouping and separation of people in harm. Our intuition is that Fonda

does not have to travel across the country to save someone’s life by magically

touching the latter’s brow. But contrast this refusal and our lenient attitude towards

such inaction with a case in which, throughout his career, Fonda never spends a cent

of his earnings except for the minimum necessary for room and board. Then, at the

age of sixty-five, he takes all his life’s savings with him onto a boat to travel abroad

to finally enjoy his earnings in a luxurious retirement. But his boat collides with

another ship and both go down. Fonda is alone on a life boat with all of his earnings

in the uninsurable form of gold coins, jewels, and suitcases of cash. He sees

someone from the other boat drowning, but he can only pull him on board if he

throws all his savings overboard where they will be irretrievably lost. Our dominant

reaction is that he must give up all his money which means he basically worked his

whole life for free. Now if he must do this, then he surely must fly across the country

to save a life in Thomson’s scenario because that is far less demanding. We believe

projective grouping explains the different reactions people may have to the two

cases. Both shipwrecked men are basically in the same dangerous maritime

situation, while in the Thomson scenario, one does not group far away and

uninvolved men together, which does not seem to give the ill person a right that

another man, Fonda, who is far away and uninvolved, come to his aid.

We can further see the psychological phenomena of projective separation and

grouping at work in a case in which a runaway trolley is made to jump its tracks by a

person who knows that it will roll for five miles until it comes to a stop and kills an

old woman in her home watching television. This person who derails the trolley

does so in order to prevent it from killing two people who have been trapped on the

tracks. We imagine that many readers would not be psychologically able to redirect

the trolley in the just mentioned way. Even if the reader could ‘‘stomach’’ making

the trolley leave its tracks in such a situation, she or he would likely find that it is

much harder to bring about the distant death of the elderly woman while she is

relaxing on her sofa in front of her television than if there is a heavy fellow on a

second fork of a looped track on to which one could switch the trolley in order to

save the lives of two other track-bound innocents.
19

Moreover, if the trolley has

been switched by someone else, fewer people will help the hefty man get off the

tracks. But we expect that most people will be much more willing, as well as

consider themselves much more justified, to help someone disconnect the violinist.

Now, while projective grouping should be seen as psychologically efficacious, it

should not be interpreted as morally relevant. We are assuming that the reader will

18
The bearing of projective separation and projective grouping on abortion is explored in more detail in

Hershenov [28].
19

Thomson herself says it would be permissible to switch the trolley and thus to use the hefty person as a

means to saving the track-bound persons [29, p. 102]. That the person on the looped track is used as a

means to the others’ survival makes the example more analogous to the violinist using someone for

support than the standard trolley example.

D. B. Hershenov, R. J. Hershenov
123

find this obvious now that the operations of projective grouping and separation have

been pointed out. When all the parties involved are innocent in the relevant sense,
20

one should just minimize harms. Their location does not matter morally. Projective

grouping and separation merely explain why it is difficult to always minimize harm

amongst innocent victims.
21

Embryos are parts of the mother, newborns are not

There are a number of philosophers who believe that it is significant that the fetus is

a part of the mother [30–33]. Kingma [5] may be the most metaphysically

sophisticated and she contrasts her view with Barry Smith and Berit Brogaard’s

[34], who claim that the fetus instead stands to the mother in an occupant or niche

relationship roughly analogous to the astronaut in the spaceship [5, p. 33]. Kingma

provides good reasons to think that the fetus is actually not an occupant of a

maternal niche but is rather a literal part of the mother. The fetus seems bound to the

mother much in the way the stalks of other organs are connected to the rest of the

body. We do not quibble here with Kingma’s metaphysics of fetal parthood, but just

show that morally, it offers abortion defenders little help.
22

We suspect that there are no moral differences if the fetus is a part of the mother

rather than an independent substance. Autonomy, privacy, and non-interference do

not hinge on the question of the fetus’s parthood. If the fetus does not undergo

substantial change with birth, then we do not see much moral significance in its

parthood status. In fact, we think that if anything, it hurts the pro-choice position for

two abortion defenses are no longer available. The first is that abortion must be

accepted for the fetus violates the bodily integrity of the mother. But if the fetus is a

part of the mother, then it cannot violate her bodily integrity. Only something that is

not a part of her body can violate her bodily integrity. It could be that it violates her

autonomy, but that is a different matter. The second loss for a pro-choice position is

that the fetus cannot be a trespasser if it is part of the mother. One’s part cannot

trespass upon oneself. Thus it cannot be claimed that the fetus is a trespasser who as

20
This ‘‘relevant sense’’ is that they are not responsible for the harm or have any greater duty to risk such

harms as perhaps soldiers and police and maybe even trolley track workmen have on certain occasions.
21

It is worth pointing out that we have taken on the strongest version of Thomson’s position, one whose

appeal is strengthened because it lacks certain analogies with abortion and assumes the rejection of

certain common sense moral assumptions. If the violinist, a stranger whose predicament one is not

responsible for, must be saved, then many would grant that there is an even stronger case for supporting

the fetus that is one’s own child and who is in need because of the mother’s choice, in non-rape induced

pregnancies, and can only be removed by being killed. (1) It is commonly held that we have special

obligations to our children that are not consent based. (2) It is also widely held that being responsible for

another’s predicament provides some obligation to ameliorate the situation. (3) Finally, it is typically

maintained that killing is worse than letting die. We have not helped ourselves to any of these claims in

contesting Thomson’s violinist thought experiment. Adding them to the mix just strengthens our pro-life

position.
22

If Kingma is right about the fetus being a part of the mother, there is only a morally significant impact

if this is accompanied by the successful defense of the claim that the fetus is not a human being but

undergoes substantial change and is replaced by a human being that comes into existence with the

separation of birth. Reasons to doubt this claim are presented below in the main text.

If Abortion, then Infanticide
123

such has no right to be in the mother’s body if literally a part of the mother’s body.

It is, on the other hand, conceptually coherent to claim that the mother has the right

to remove the fetus, as she does with other unwanted parts, but that is just an

autonomy right and is independent of the parthood relationship. Thomson,

incidentally, recognized this. She concludes her famous paper with what seems to

be a recognition of fetal parthood, claiming, ‘‘A woman may be utterly devastated

by the thought of a child, a bit of herself, put out for adoption and never seen or

heard of again’’ [1]. So, she relies upon bodily control or autonomy considerations

despite apparently accepting the feminist position that the fetus is a part of the

mother.

If autonomy is taken to the extreme, then that will allow a woman to control her

body as it supports another, even if that other is not a part of her but just lies within

or on top of her. Of course, we do not believe that autonomy rights justify abortion.

Nor do we see any reason to believe why the autonomy right is made any stronger

by the fetus being a part of the mother rather than being inside her body without

being a part of it. It does not matter if the fetus is a part of the mother’s body rather

than an occupant within her body putting great strain on it. This is especially clear in

the case of conjoined twins, who share parts that are essential to the life of each.

Neither twin will be able to control that shared part and take it with her upon

surgical separation, even though it is a part.
23

So parthood per se does not matter

morally. What matters morally is due to other factors like the value of the conjoined

twins and their capacity to be harmed and benefited.

Kingma thinks that the fetus’s mereological status as a part of the mother

produces a dilemma—either the fetus is a part and thus there can be human beings

within larger human beings, which would violate the maximality principle that

entities of the same kind cannot be parts of each other, or the fetus is a part and does

not become a human being until birth when it is separated. Kingma prefers to accept

the second horn. We do not think the first horn is very sharp.
24

The second horn

would render abortion more akin to contraception in that it keeps a human being

from coming into existence. And this would apparently provide a principled way to

distinguish abortion

from infanticide.

It might be thought that treating the fetus as a part that undergoes substantial

change at birth will provide a way to distinguish abortion from infanticide. Abortion

does not kill a human being but just a precursor to a human being. It is more like

contraception in that sense. It is only infanticide that terminates a human

being.

However, the background metaphysics will turn out to make it the case that

infanticide has already been occurring and could occur in the future in cases that

23
Likewise, imagine that only part of the fetus is a part of the mother. The mother could not do what she

wants with that part because it is also a part of her. We do not see why a different treatment would be

called for if the fetus were completely a part of the mother or one twin were completely embedded within

another.
24

It is counterintuitive to have adult organisms within adult organisms but it does not strike us as that

odd to think of fetuses as parts. They are special parts in that they are designed to separate and grow and

flourish (unlike other parts that are designed only to separate—sperm, baby teeth, etc.) Human beings

within human beings certainly does not strike us as more counterintuitive than the recognition that male

fetuses are parts of their mothers, such that the mother has a penis, four eyes, and four legs. The sting can

be taken off if this is understood to be just a temporary situation of a young human being within another.

D. B. Hershenov, R. J. Hershenov
123

will surely be objectionable. To illustrate the latter, imagine the newborn has not yet

had its umbilical cord cut. Technically, it is still a part of the mother even though it

has passed through the birth canal and is in the arms of the doctor or nurse. To kill it

would be infanticide. One might insist that it is not yet a newborn or infant for it is

still attached. But we doubt that would convince many ordinary English users.

Anyway, we can also imagine the nursing newborn, after the umbilical cord is cut,

secreting a bonding solution that temporarily attaches her to the mother’s breast in

such a way as to meet the parthood criterion. Few readers would accept that

attachment is infanticide because a part to whole relation is established, or that the

attached could be killed, or that anything would cease to exist once the nursing

newborn is later detached.

If separation from the mother’s body is what transforms a fetus into an infant,

then if the fetus breaks loose from the uterine wall or the mother’s placenta, then

it would be an infant for it is no longer part of her body, even if it is still inside

her.
25

Ironically, surgery to repair the connection would be infanticide, or the

killing of a human being, for that would render the human being a part of the

mother again. Moreover, if any abortion proceeded by first removing the fetus

from the uterine wall before it died, that would end as infanticide as the parthood

relation would be severed.
26

So if coming through the birth canal is not what

makes one an infant but the loss of parthood status, then the detached embryo is

an infant within the mother’s body though not a part of the body. The infant is an

occupant in her womb akin to the way the present reader is an occupant in his or

her office.

The second horn of Kingma’s dilemma introduces a very bizarre metaphysics of

organisms that pops in and out of existence. If organisms cannot be parts of another

substance, then does the premature newborn go out of existence when connected to

the incubator in certain ways (connected in whatever way is required for parthood)

and pop back into existence when removed? That strikes us as preposterous. We do

not see why it would matter that the ‘‘incubator’’ is one of the same kind, another

human being, especially if the parthood bond is structurally the same. Anyway, the

secretion that temporarily bonds the nursing baby to the mother will be a case of an

entity in another of the same kind. If it is claimed in response that the nursing baby

and the mother would just share a part, we would reply that the same can be said

about the embryo when it is in the mother’s womb.

25
Did the embryo go out of existence when it became embedded in the uterine wall? That is hard to

believe. We doubt that there is a principled distinction that can be made between before and after

implantation, where it was one kind of substance during the first 5–7 days post-fertilization, then another

at implantation, then another at birth.
26

Any drug that prevents the early embryo from embedding in the uterine wall would also be infanticide

unless being an infant entailed having been born. We doubt this is a conceptual truth as it appears not to

be a mistaken use of the word infant to describe motherless very young children created by God or made

in a lab as ‘‘infants.’’

If Abortion, then Infanticide
123

Why infanticide is wrong

Some readers might admit that abortion defenses are also defenses of infanticide but

also accept that infants as well as fetuses can be killed. We are skeptical of the

claims of Jeff McMahan [13] and others (e.g., Peter Singer [12], Michael Tooley

[11]) that newborns and the unborn lack the interests necessary for a right to life.

We think that they fail to distinguish something being in an individual’s interest

from that individual taking an interest in something.
27

It is in the embryo and

neonate’s interest to live on even though they have not taken an interest (i.e., desire)

to live further into the future. Analogously, vegetables are in a child’s interest but he

is not interested in them. All living things have an interest in healthy development.

We can ascribe interests to potential persons, even mindless ones, to live and

develop in a healthy fashion by which they will flourish. It may even be that

consciousness evolved to promote a well-being that organisms had previously

furthered without awareness of doing so. If one does not accept that non-sentient

beings can have welfare, then one will be unable to explain the harm of a person

lapsing into a coma or the benefit of someone coming out of a coma, for harms and

benefits involve changes from one level of well-being to another, not a move to or

from the absence of any well-being. There is a difference between the absence of or

no well-being on the one hand and zero or low-level well-being on the other. We

were all devoid of any level of well-being (even zero) before we existed and that

explains why coming into existence is not a benefit. The comatose have zero or low

well-being, unlike nonexistent artifacts, mountains, and so on, which have no well-

being.

Our contention is that all living entities are capable of well-being and have an

interest in their own good.
28

Even blades of grass can be said to literally thrive and

thus have an intrinsic well-being and a nonmetaphorical interest in sun and nutrient-

rich soil. Despite having interests, however, a blade of grass has a future that is not

very valuable, so its interests are given far less moral weight than those of human

beings. Assuming that the degree of the harm of an entity’s death depends, in part,

upon the value and extent of the well-being that it loses out on, the grass is harmed

very little. The same is true for most non-human animals.
29

A healthy human fetus,

on the other hand, has the potential to realize mental capacities of considerable

value that will enable it to flourish to a considerable extent.

We think it is revealing to note the structural similarities between health and

well-being. We speak of the diseased as doing poorly, the recovering as doing

better, and the healthy as flourishing. We likewise describe those who undergo

significant drops in well-being as doing poorly, who undergo increases in well-being

as doing better, and who experience an abundance of well-being as flourishing. It is

27
This distinction is found more often in the environmental than bioethical literature. See Tom Regan

[35] and Paul Taylor [36].
28

We are not denying that there could be non-living but conscious entities which have interests and well-

being.
29

So, our theory of interests and harms does not provide any additional reason to be a vegetarian or to

treat animals better.

D. B. Hershenov, R. J. Hershenov
123

not metaphorical to claim that the healthy are thriving or that those with

considerable well-being are also. It is good for a plant or fetus to thrive. The causes

and constituents of their flourishing are in their interest.

We maintain that the morally relevant sense of potential is determined by the

healthy development of the kind of organism in question.
30

Every living entity has

an interest in its own healthy development. What is healthy development is not

determined by active or intrinsic potential. Those with congenital disabilities, even

the anencephalic, have the potential to be healthy members of their kind (though

intervention is needed) and have an interest in a cure. This is why those with severe

cognitive impairments should receive the only dose of a person-producing serum

rather than say a normal feline fetus. The latter is not unhealthy and its interests, like

that of all mindless creatures, are limited to its healthy development. This explains

why we reject McMahan [39, p. 354] and James Rachels’s [40, p. 173] defense of

moral individualism, which is the doctrine that the treatment of an individual ought

to be determined not by any group membership but by respecting the individual’s

own particular characteristics. If readers think that healthy development cannot be

morally significant and be a basis for interests relevant to our well-being because

these interests are not determined by intrinsic properties, then they should reflect

upon the lessons of semantic externalism. The beliefs and desires we have are

determined and constituted, in part, by the external environment, not solely by what

is in our head. Yet, they are certainly relevant to the value of our interests and our

being harmed or benefited.

Mindless organisms only have interests in healthy development or proper

functioning and the flourishing that involves. So, an embryo has an interest in

growing a healthy, properly functioning brain but no interest, then, in becoming a

football player, even if it later dreams of Super Bowl fame as an adolescent. It is not

enough for a mindless entity to be identical to a later being for it presently to have

an interest in that later being’s welfare. The future good must be in the mindless

being’s interest when it is mindless. And the only basis we can see for ascribing

interests to the mindless is by appealing to the good realized by their proper

functioning, i.e., healthy development for entities of that kind. Health is a necessary

condition for flourishing and constitutive of a good deal of valuable well-being in a

healthy person. The living will always have an interest in health-produced

flourishing. All flourishing depends upon health being present (to some) degree and

every living being has an interest in health at every stage of its life, including its

embryonic stages. When it is mindless, there is probably nothing else to its good

than its health, i.e., its proper functioning is constitutive of its flourishing. But that is

still very valuable and is why infanticide is a great wrong.

30
We have argued elsewhere that this conception of potential avoids all the reductios of potential

[37, 38]. It does not matter that the cells of the early embryo are totipotent, human somatic cells can be

cloned, gametes can have their development induced parthenogenetically, oysters can become persons on

alien environments, or kittens can be injected with a serum that produces personhood, etc. None of these

developments are such that the cell or multicellular creature would be unhealthy if they did not transpire,

so they are not in the interests of such creatures. The mindless (and for the most part, the minimally

minded) only have interests in their healthy development.

If Abortion, then Infanticide
123

The reason a reader’s death is worse for her than the fetus or infant’s death is for

the fetus or infant is that the reader has acquired many interests that she did not have

earlier. Her environmental interactions give her interests in, say, football, or

interests to engage in particular projects with friends and lovers. The embryo just

has an interest in healthy development, which involves becoming able to reason,

care, empathize, love, exercise self-restraint, and so on. But the embryo or infant is

without the detailed and contingent interests that will arise from doing things with

families and friends in certain environments. So, death does not frustrate as many

interests and harm the embryo or infant to the degree that it does the reader or, say,

her mother. But as long as one’s attitude is that infanticide is a great harm and

wrong, even if it is not as bad as killing the reader, then abortion too is a great harm

and wrong.
31

Potential versus rearing relationships

We believe it is the human potential for healthy development that distinguishes

human infants and fetuses from other non-human animals that then are intrinsically

similar in terms of intrinsically manifested mental abilities. But our appeal to the

norms of healthy development is not the only theory that claims that manifested

mental traits are not the key to understanding the moral status of the very young or

undeveloped human being. Jaworska and Tannenbaum explain the moral difference

between, say, a dog and a human baby based on the latter’s participation in what

they call ‘‘person-rearing relationships,’’ which can ‘‘transform metaphysically and

evaluatively the baby’s activities’’ [4, p. 242].

Jaworska and Tannenbaum draw on ideas in action theory to suggest that

potential persons can acquire considerable moral status from their extrinsic

relationship to those who are rearing them. The end to which some action is geared

can determine that action’s nature and value. One of their examples is that there is

little value in a youngster acquiring abilities to be sensitized to feel what others do

31
It should not be thought that our claim that embryos, fetuses, and infants have interests in healthy

development is what makes any argument for abortion into an argument for infanticide. This was a charge

of an anonymous referee. We certainly do not claim or assume that the principle of our positive view

about death harming mindless human beings by depriving them of a healthy and valuable development is

why certain abortion defenses also apply to infanticide. We just aim to show that the features lacking in

fetuses that appear to justify abortion according to its defenders are also lacking in infants and so would

‘‘justify’’ killing them. People have the intuition that infanticide is wrong independently of anything we

believe or stated. We are offering a theory explaining why they may hold that infanticide is wrong, which

also explains why abortion is wrong. Our theory explaining the harm to the mindless need not be accepted

to see why viability, consciousness, and inequality are not morally significant justifications for granting

older fetuses and infants immunity from killing. Readers do not need to agree with our theory of what

makes killing wrong to see that consciousness and viability fail to pick out morally significant features or

that, deep down, they really are not committed to viability and the onset of consciousness as abortion cut

off points but instead attracted to the timing of their instantiation. Our anti-Thomson view that morality is

very demanding can be appreciated independently of our accepting our principle about the potentiality of

the mindless. Equality too can be seen as insufficient to justify a right to abortion independently of our

view about interests in healthy development for it permits infanticide where there is inequality and it does

not protect abortion rights where there is equality.

D. B. Hershenov, R. J. Hershenov
123

so he can manipulate them, but considerable value in training an intrinsically similar

youngster to learn how others feel so he will be able to provide them assistance and

respect. The different ends of the parents (‘‘rearers’’), of which the children

(‘‘rearees’’) are unaware, render the children respectively proto or incomplete

realizations of viciousness or virtuousness. So, Jaworska and Tannenbaum argue

that it is the rearing relationship of potential people like nine-month-old infants that

imbues them with a moral status that mentally equivalent dogs do not have. This

would seem to distinguish fetuses who cannot stand in a rearing relationship with

those infants who can [4, pp. 250–251].
32

The latter have moral status that

approaches that of self-standing persons
33

because they are on their way to

becoming persons in virtue of the nurturing rearing relationships

[4, p. 256].

Even

if they are abandoned or neglected, the authors claim that the potential of someone

to stand in a rearing relationship bestows value and distinguishes early abortion

from infanticide.

It seems to us that Jaworska and Tannenbaum’s account of moral status cannot

prevent infanticide since a newborn cannot, any more than an advanced fetus, be in

a person-rearing relationship. They toy with the idea that caring is sufficient for

moral status, writing, ‘‘emotional attachment is present in unimpaired neonates’’ [4,

p. 269]. That might allow newborns to be involved in ‘‘incomplete realizations of

self-standing person activities’’ [4, p. 254]. Nevertheless, Jaworska and Tan-

nebaum’s paper fails to protect against the infanticide of those born prematurely or

with a temporary developmental impairment that prevents emotional attachment.

What is especially revealing is that their account fails to protect hypothetical

creatures that are potential persons very much like us but who become persons due

to their being hardwired to develop on their own rather than through undergoing a

rearing relationship.

We argue that any appeal of Jaworska and Tannenbaum’s argument is due to an

accidental generalization. A potential for healthy development like that described in

the previous section, not the person-rearing relationship, is doing all the moral work.

We contend that Jaworska and Tannenbaum have not found even a sufficient

condition for moral status. This can be seen by attending to the following imaginary

scenarios.

First, imagine a species whose young are mentally comparable to our own very

young children, that is, with abilities that do not surpass a puppy’s. These children

32
They write, ‘‘Anencephalic infants and early fetuses are certainly incapable of engaging in activities

modeled after SSP (self-standing person) activities, and so would not gain a high moral status via our

account, but this we think is an advantage’’ [4, p. 269, fn. 48]. We wonder why the ends of the mother to

gestate her child and who behaves with an eye towards developing that child into a healthy person

(exercises, eats, and drinks appropriately, takes prenatal vitamins, visits the obstetrician) do not bestow

great value on her fetus by her actions. Why must the entity she acts for and upon be a conscious

participant in the telos? Jaworska and Tannenbaum admit that the rearee does not have to be aware of the

rearer’s ends.
33

‘‘Self-standing person’’ is Jaworska and Tannenbaum’s name for the individual who has the relevant

sophisticated cognitive capacities that bring higher moral status. They are neutral about whether this is the

capacity to reason, to be self-conscious, capable of caring, etc.
34

‘‘For all we know, the infant’s moral status may be the same as the status of the self-standing person’’

[4, p. 256].
If Abortion, then Infanticide
123

naturally develop from such dog-like states on their own to self-standing persons

without the interaction of rearers. Do they have the same moral status (at this

stage) as a dog, or less than an incomplete self-standing person? Surely, they do

not. It thus seems that rearing is just a form of potential, such that the potential

does all the real work in our moral attitudes. That is why the moral status of the

hypothetical species of persons with dog-like young would be the same as that of

our own infants involved in rearing relationships. They both would be protected

against infanticide much as a person is protected against being killed. Of course,

Jaworska and Tannenbaum can argue that since they are only providing a

sufficient condition [4, p. 245, fn. 11], something else governs the moral status of

our conjectured species. But that strikes us as a desperate move akin to admitting

that rearing is not doing any moral heavy lifting, for then, everywhere there is a

rearing relationship there is potentiality as we conceive of it. They are better off

denying that they have this intuition or arguing that those of us who do have it are

misguided in believing the young of such a ‘‘self-rearing’’ species would have

considerable moral status.

Secondly, imagine that an inept and non-caring rearer is unintentionally rearing a

person though trying to do something else. Perhaps the rearer wants a cognitively

disabled child for mean-spirited reasons and should be condemned just like the

parent in the authors’ example who taught his kid to be emotionally sensitive to

others in order to manipulate them. Would that incomplete self-standing person not

have greater moral status than the cognitively equivalent dog, even though the end

of personhood is not being aimed at by the rearer? Again, it seems that Jaworska and

Tannenbaum could not protect such infants. However, they do write elsewhere that

‘‘while the rearee’s special moral status can be traced to the context of a caring

relationship, it is not being cared about that grounds this status but rather being able

to engage in activities transformed by the context of a caring (person-rearing)

relationship’’ [4, p. 257]. So, they could claim that although the child of the inept

rearer is not in the right rearing relationship, the potentiality to be so reared is what

conveys moral status. But by attending to the next three examples, we show that this

is not a sufficient condition because the rearees there do not have moral status. That

should make readers suspicious of the claim that the rearing-rearee relationship is

doing any moral work in the above cases.

Jaworska and Tannenbaum admit that if a newborn is abandoned, he would have

moral status not because he is actually in a rearing relationship but due to the

weaker condition that he could be. They write that it is not ‘‘required that someone

in the vicinity exists who can adopt this end’’ but ‘‘only that such a person will, or

perhaps, even could exist.’’ The weaker condition, they believe, ‘‘is warranted’’ [4,

pp. 268–269]. But the weaker condition produces implausible duties in a modified

version of Uriah Kriegel and Nicole Hassoun’s [41] case of hypothetical earth

oysters that develop into persons if brought to a Martian atmosphere. Imagine if our

pigs could develop into persons in response to rearers on Mars. Since we would

have no duty to treat them as having a special moral status, it seems evident to us

that the rearing relationship is not sufficient for moral status.

Imagine also Tooley’s famous kitten, prior to the injection of the person-

producing serum, being reared to become a person with the end of later injecting

D. B. Hershenov, R. J. Hershenov
123

it.
35

Surely it does not have greater moral status than a normal kitten or a normal

nine-month-old human. And surely we do not have any duty to inject it despite it

standing in a rearee relationship with a possible end of enhancement. Why not?

Becoming a person is not part of a healthy development for kittens, so the kitten

does not have an interest in such enhancement.

Moreover, most of us share McMahan’s intuition that we do not have a moral

duty to develop dogs if they should turn out to have the unusual ability to learn

language, pace Jaworska and Tannenbaum’s claim suggesting we do.
36

McMahan

imagines that there is a type of dog that if we spent nearly every waking hour

training in speech, could realize a formerly unknown potential ability for such dogs

to speak. Why do we not have a duty to enable them to so develop, while we do

have a duty to spend almost comparable hours training human children to speak?

We explain this by claiming that language learning is not part of a healthy

development and flourishing for dogs. The dogs did not evolve or were not designed

for such development. They are not pathological if they do not so develop. So they

do not, before or after birth, have an interest in becoming speakers. Our view, of

course, allows that once they are speaking persons, they will enjoy that state and

want to retain their personhood. The same is true for Tooley’s kitten. Nevertheless,

they are not harmed if they do not undergo such development for they have no

interest in such development. It is not their healthy or proper functioning in their

design environment. It is important to realize that we can always conjecture a

hypothetical environment where the simple-minded will become geniuses. That

environment, which is not the creatures’ design environment, might even be a very

changed pattern of species interaction or the presence of some new chemical in our

own geographical region.
37

Finally, the person-rearing relationship account of moral status cannot account

for why people would feel more obliged to give scarce person-producing medicine

to the congenitally disabled human fetus or anencephalic human infant, who are

mindless or minimally minded [4, p. 255, fn. 25], than to the ordinary dog fetus, the

ordinary dog, McMahan’s special dogs, or Kriegel and Houssain’s oysters. If one of

those unusual dogs or oysters were missing a chemical that they needed to learn

language or become a person in Mars, respectively, then the issue of who receives

the scarce medicine certainly would not be a matter of a coin toss. We would give

the human child the medicine, and we would do it not because of special obligations

or harms to those to whom the child stands in relationship but for his or her own

sake. The child has an interest in such healthy development.

35
Jaworska and Tannenbaum rule out the fact that a primitive culture’s belief that dogs can become

persons can bestow moral status on their actions towards the dogs for there is a failure of a feasibility

requirement on the ends of actions affecting their nature and value. But we can make Tooley’s felines

require some rearing in order for the person-producing serum to be effective.
36

The authors write that those dogs ‘‘are paradigmatic rearees’’ [4, p. 255, fn. 27]. We share McMahan’s

belief that they are not owed such development and can appeal to our account of interests in healthy

development to justify and explain such intuitions.
37

The non-design environment could involve a presence of chemicals—like that found in the Mars

atmosphere imagined by Kriegel and Houssain—three miles below or above the reader.

If Abortion, then Infanticide
123

Conclusion

We have shown that six well-known arguments for abortion are also arguments for

infanticide. If infanticide is beyond the pale, then such arguments cannot justify

abortion. Defenders of abortion have overlooked the fact that the mindless can have

interests in their own healthy development. We suspect that the acceptance of

infanticide is based on a similar failure to distinguish between something being in

an individual’s interests and that individual taking an interest in something. It is in

the interest of both fetuses and infants to undergo healthy development: they are

benefitted when they do and harmed when they do not.
38

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38
We would like to thank Catherine Nolan, Joel Potter, Peter Koch, and the members of Plato’s

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issues.

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If Abortion, then Infanticide
123

COMMENTARY Open Access

Why Ectogestation Is Unlikely to Transform
the Abortion Debate: a Discussion of ‘Ectogestation
and the Problem of Abortion’

Daniel Rodger1

Received: 9 October 2020 /Accepted: 22 October 2020/
# The Author(s) 2020

Abstract
In this commentary, I will consider the implications of the argument made by
Christopher Stratman (2020) in ‘Ectogestation and the Problem of Abortion’.
Clearly, the possibility of ectogestation will have some effect on the ethical debate
on abortion. However, I have become increasingly sceptical that the possibility of
ectogestation will transform the problem of abortion. Here, I outline some of my
reasons to justify this scepticism. First, I argue that virtually everything we already
know about unintended pregnancies, abortion and adoption does not prima facie
support the assumption that a large shift to ectogestation would occur. Moreover,
if ectogestation does not lead to significant restrictions to abortion, then there will
be no radical transformation of the practice of abortion. Second, abortion is
already associated with stigma, and so the presence of ectogestation would need
to create additional stigma to modify behaviour. Finally, I argue that ectogestation
shifts the debate away from the foetus to the human subject of the artificial
womb—the gestateling, therefore creating a new category of killing—gestaticide.
However, this would only reorient the debate rather than end it.

Keywords Abortion . Pregnancy . Infanticide . Gestation . Ectogestation . Adoption

1 Introduction

Christopher Stratman (2020) defends the claim that there is no right to the death of the
foetus when ectogestation is possible, even if they lack the moral status of a person.

Philosophy & Technology
https://doi.org/10.1007/s13347-020-00436-1

* Daniel Rodger
daniel.rodger@lsbu.ac.uk

1 School of Health and Social Care, London South Bank University, 103 Borough Rd., London SE1
0AA, UK

http://crossmark.crossref.org/dialog/?doi=10.1007/s13347-020-00436-1&domain=pdf

http://orcid.org/0000-0002-2121-7167

mailto:daniel.rodger@lsbu.ac.uk

This is a conclusion I have argued for previously (Blackshaw and Rodger 2019) in
response to those who have argued to the contrary (Räsänen 2017).1 Though there are
many arguments against the claim that there is a right to the death of the foetus, it seems
unlikely that the possibility of ectogestation will radically transform the abortion
debate—especially that it will cause a reduction in the incidence of abortion.

Here, I briefly outline some challenges against Stratman’s (2020) claim that the
possibility of ectogestation—a period of gestation in an artificial ex utero
environment—will radically transform the problem of abortion. First, I argue that virtually
everything we already know about unintended pregnancies, abortion and adoption seems
to suggest that a large shift to ectogestation is unlikely to occur. Moreover, if ectogestation
does not lead to significant legal restrictions on abortion, then there is unlikely to be any
radical transformation on the practice of abortion. Second, abortion is already associated
with stigma, and so the presence of ectogestation would need to increase the existing
stigma to modify behaviour away from abortion. Finally, I argue that artificial womb
technology shifts the debate away from the foetus to the human subject of the artificial
womb—what Elizabeth Chloe Romanis (2018) has termed the gestateling. It creates a new
category of killing—gestaticide—which will more closely resemble the ethical debate
around infanticide rather than abortion (Rodger et al. 2020).

2 Adoption, Harm and Stigma

Women who have an unintended pregnancy can already entrust the moral and legal
responsibilities of parenthood to a competent individual or couple—via adoption. In
many ways, ectogestation allows for the same opportunities as adoption. In both cases,
the resulting gestatelings’ or neonates’ needs are met by something or someone else.
Moreover, both provide a means for continued human existence, in contrast with
induced abortion. One obvious difference is that in the case of ectogestation, the period
of gestation would be less than completing a normal pregnancy (e.g. perhaps they could
be transferred to an artificial womb at 24 weeks); otherwise, there would be little reason
to opt for ectogestation over adoption in the case of an unintended pregnancy.

Women with an unintended pregnancy are the group most likely to have an abortion,
with 61% of unintended pregnancies between 2015 and 2019 ending in abortion
(Bearak et al. 2020); globally, 25% of pregnancies end in abortion (Sedgh et al.
2016). Therefore, ectogestation would need to be employed very early on in the
pregnancy—because women who would otherwise seek an abortion will likely not
want to be delayed in relieving the burdens they perceive or associate with their
pregnancy. In most high-income countries, at least 90% of induced abortions are
completed before the 13th week of pregnancy (Popinchalk and Sedgh 2019). Most
women who consider abortion do not choose to complete the pregnancy and give their
child up for adoption (Sisson et al. 2017). Unless it is medically indicated, women do
not and are not legally permitted to request to deliver their foetus prematurely at the
point of viability (24–28 weeks) with the intent that the child receive neonatal intensive
care under the responsibility of adoptive parents. If ectogestation is to function as an
alternative to abortion, this is what women would be expected to do. However, based

1 As have many others, see Mathison and Davis (2017), Hendricks (2018), and Kaczor (2018).

D. Rodger

on what is already known about women who consider and procure abortions,
ectogestation would need to be available at a much earlier stage of pregnancy than
the point of viability.2

The reasons for not opting for foetal transfer surgery, ectogestation and adoption are
likely to be similar or the same as those given for not completing the pregnancy and
giving the child up for adoption. In fact, there are additional reasons for women to
object to this process—the need for invasive surgery to transfer the foetus into an
artificial womb despite the fact that abortion obtained early in pregnancy is relatively
safe for women (National Institute for Health and Care Excellence 2019).

The invasive surgery required for a foetal transfer is likely to be analogous to the
surgery required for a caesarean section, and therefore, the risks involved will be
closely aligned. Given that the vast majority of induced abortions occur before the
13th week of pregnancy, the overall risks (e.g. rates of serious complications) are likely
to be lower—where abortion is legal—than those that would be associated with foetal
transfer surgery, if they reflect the risks associated with caesarean section.3 This in itself
is not an argument for abortion; otherwise, the increased complication risks associated
with naturally giving birth compared with early abortion could be used to argue that
abortion would be clinically indicated for all pregnancies.4 This point merely shows
that the increased risks that would be associated with foetal transfer surgery, when
compared with the comparatively lower risks of early induced abortion, are likely to
reinforce the decision to opt for abortion and not ectogestation.

In a study of women in the USA who had abortions, the reason they gave for not
giving their child up for adoption was that giving up one’s child was considered
morally unconscionable (Finer et al. 2005). This is congruent with the existing research
that explores women’s views of ectogestation compared with abortion (Cannold 1995;
Simonstein and Mashiach-Eizenberg 2009). In a qualitative study by Leslie Cannold
(1995, p.60), adoption (and ectogestation) was understood by some women as an
‘irresponsible abdication…of their maternal responsibilities’. Furthermore, the use of
ectogestation for resolving an unintended pregnancy was viewed negatively by women
irrespective of their views on abortion, even when ectogestation was described as no
more medically risky or inconvenient than abortion (Cannold 1995). This means that
even if there is no right to the death of the foetus, the possibility of ectogestation is
unlikely to affect women’s decision-making if adoption is perceived as being psycho-
logically distressing (Jones et al. 2008).

The primary reason that we would expect women to opt for ectogestation would be if
legal restrictions were implemented against abortion based on the presence of artificial
womb technologies. This is of course theoretically possible but improbable—especially
in countries where legal abortion is not connected to foetal viability. It would require a
significant shift in the current cultural and international trajectory of abortion legislation.
This trajectory is evidenced by the trend towards decriminalising abortion, most recently
in Northern Ireland in 2019 (Aiken and Bloomer 2019), and expanding the legally
permitted grounds for abortion (Guillaume and Rossier 2018). In other words,

2 Realistically, ectogestation would need to be available prior to 13 weeks to act as an alternative to abortion.
3 For a discussion of a similar point and an argument for why ectogestation should not be considered as an
alternative to pregnancy or abortion, see Romanis et al. (2020).
4 For a discussion of this point, see Blackshaw and Rodger (2020).

Why Ectogestation Is Unlikely to Transform the Abortion Debate: a…

international trends appear to be moving towards broadening abortion access, not
restricting it in ways that would be required were ectogestation to become available.

A central question, therefore, is this: if—many or most—women who are consider-
ing abortion tend to pursue abortion rather than adoption today, what reason do we
have to think this will change when ectogestation becomes a reality?

First, given the additional risks that are posed—however small—there does not seem
to be any obvious reason why women who would consider abortion would opt for
ectogestation when they so rarely choose to complete gestation (or at least wait until
viability) and then give their child up for adoption. In fact, not only are there risks
posed by surgery, but presumably there would also be some risk to the foetus from the
transfer to the artificial womb, risks that are likely to outweigh those it would be
exposed to if the pregnancy was left uninterrupted. Ectogestation, if completed around
the time that most abortions are completed, would entail that women with an unin-
tended pregnancy are spared the responsibilities and challenges of an extended period
of pregnancy, but if one intends to give one’s child up for adoption—for the child’s
long-term benefit—then why not opt for completing the pregnancy without all of the
additional risks? The artificial womb technology being developed is aimed primarily at
reducing neonatal mortality caused by premature birth (Partridge et al. 2017) and would
likely be utilised by women experiencing a pregnancy that poses a risk to their own
health (Romanis et al. 2020). It is not being developed as an alternative to abortion as
the technology is not expected to be within the purview of early pregnancy. If
ectogestation entails a risk to the mothers’ health and an additional risk to the
gestatelings’ health and adoption is viewed by women considering abortion as psy-
chologically harmful and morally irresponsible, then ectogestation is unlikely to radi-
cally transform the problem of abortion.

Second, one must consider the potential social changes that the possibility of
ectogestation could bring about. Artificial gestation compared with natural gestation
would be visible—gestation becomes observable in a way that was only possible
infrequently under ultrasound. This is not beyond the realms of possibility as the
Biobag used to gestate lamb foetuses for up to 28 days by Partridge et al. (2017) was
transparent and therefore observable throughout the process. Artificial gestation could
become something of a spectacle that can be enjoyed by the parent/s, family, friends
and the community. It may also have the effect of humanising the subject of
ectogestation—the gestateling—and creating increased stigmatisation of induced abor-
tion. It is possible that ectogestation will cause an increase in stigma that could
discourage some women from obtaining an abortion. However, given the risks in-
volved with ectogestation outlined above, an increase in stigma towards abortion may
lead to an uptake in adoption without the use of ectogestation. Moreover, stigma
against abortion already exists (Cárdenas et al. 2018; Biggs et al. 2020), and adoption
is already an option. Ectogestation, therefore, would have to create additional stigma to
have any real effect on the incidence of induced abortion.

3 Problems That Must Be Overcome

The problems I have outlined are not insurmountable. It could be the case that
ectogestation can one day start safely from the first trimester of pregnancy; there are

D. Rodger

hundreds of thousands of individuals or couples willing to adopt; foetal transfer surgery
turns out to be low risk and without much inconvenience; restrictions to legal abortion
are implemented in several countries; and there is both the technological and medical
capacities to support hundreds of thousands of gestatelings each year. On balance, I
think each of the scenarios I have described is unlikely to materialise to the scale
required to radically transform the problem of abortion.

4 A New Problem: Gestaticide

A further issue raised by transferring pregnanciesto an artificial womb is that it
means creating a new category of killing—gestaticide (Rodger et al. 2020). Gestaticide
describes the deliberate killing of the subject of an artificial womb. It has long been the
case that some philosophers have argued that infanticide is morally permissible, and
arguments that justify infanticide are likely to also apply to the gestateling. As both are
independent of the mother, the case for infanticide and gestaticide must be made on
grounds other than bodily autonomy. Peter Singer (2011) has argued that because
infants lack characteristics such as rationality, autonomy and self-awareness, then
killing them cannot be considered the moral equivalent of killing a human that does
possess these characteristics. On such accounts the newborn, like the foetus—and
gestateling—should not be understood as persons with a corresponding right to life.5

Therefore, fewer reasons would be needed to justify killing them compared to an
individual who possesses the characteristics necessary to have a right to life. Similar
arguments have been put forward by other philosophers such as Michael Tooley
(1983), Nicole Hassoun and Uriah Kriegel (2008), and Alberto Giubilini and Francesca
Minerva (2013).6 So, even if we accept that there is no right to the death of the foetus—
whilst in utero—this may only result in a new ethical debate surrounding the permis-
sibility of gestaticide—which will conceptually resemble the ethical debate surrounding
the permissibility of infanticide rather than abortion.

5 Conclusion

In summary, I have argued that even if ectogestation becomes possible, this is unlikely
to transform the abortion debate. Unless the presence of ectogestation is conjoined with
significant abortion restrictions, women are unlikely to opt for ectogestation for the
same or similar reasons that they rarely opt to give their child up for adoption.
Moreover, the additional stigma created by not using ectogestation is unlikely to be
significant enough to modify behaviour to the extent required to transform the problem
of abortion. Finally, assuming women were to transfer their unintended pregnancies to
an artificial womb for ectogestation, this would simply generate debate concerning a
new category of killing—gestaticide. Rather than ending the debate around abortion, it

5 For a discussion of moral status and the relevance of birth, see Colgrove (2019); Romanis (2019); and
Colgrove (2020).
6 More recently defended by Räsänen (2016).

Why Ectogestation Is Unlikely to Transform the Abortion Debate: a…

may only reorient it to whether—or when—it is permissible to kill humans undergoing
artificial gestation.

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Why Ectogestation Is Unlikely to Transform the Abortion Debate: a Discussion of ‘Ectogestation and the Problem of Abortion’

Abstract
Introduction
Adoption, Harm and Stigma
Problems That Must Be Overcome
A New Problem: Gestaticide
Conclusion
References

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