WHEN DOES LIFE BEGIN

 

Author:   JAMES D. DAVIS, Religion Editor     Date: Oct 10, 1989  Start Page: 1.E    Section: FEATURES LIF

Frail babies, connected to tubes and respirators, struggle for breath every day under the gaze of a Broward County nurse at a pediatric intensive care unit. Some of them weigh only a pound. Now that they're in the world, she will try to save them. But for those that were unplanned and unwanted, she would not have disapproved abortion.

"I've seen too many kids go home to no kind of home at all," says the nurse, who asks not to be identified because of hospital policy. "I've seen cocaine babies with addicted mothers. I wonder what kind of chance they'll have in growing up. That's why I'm pro-choice."

At Mount Sinai Medical Center in Miami Beach, a similar situation is played out each day. But here, another nurse takes a different view.

Elizabeth Liddle says she has never doubted that the babies under her care have been human from conception. She is concerned that in other rooms of the hospital, fetuses are being aborted.

"Everyone is concerned for themselves, their rights, their own bodies," she laments. "I think some women don't consider the rights of the baby."

-- Two opposing views, multiplied a thousand times over by doctors and nurses, pro-choice and anti-abortion activists aligning themselves on one side or the other. The U.S. Supreme Court has agonized over the abortion issue. The Florida Legislature has agreed to discuss it today in a special session. Voters are sharply split over it.

When does human life begin?

Is abortion elective surgery or infanticide?

It seems to call for a straight yes or no answer. If the fetus is human, there can be no morning-after birth control. Yet the closer one looks at the fetus, the fuzzier the issue appears.

It is this debate that has helped create the field of bioethics, a profession that has mushroomed during the past 15 years. Bioethicists work with experts in many disciplines -- medicine, philosophy, law, religion, psychology -- in an attempt to help people sort through the growing dilemmas of modern health care. They are increasingly hired on hospital staffs and sought out by government commissions.

They cannot say when human life begins. But, they say, they can help clarify the question.

"It's not a simple answer because it's not a simple question," says Laurence O'Connell, president of the Park Ridge Center for the Study of Health, Faith and Ethics in Chicago. "It depends on whether you mean cellular life, or when it becomes an individual, or when it becomes a person.

"Anyone who says he has a definition is presuming."

-- The presumptions have multiplied since July 3, when the U.S. Supreme Court, in the case of Webster v. Reproductive Health Services, let a Missouri law stand that stated life begins at conception. Already, extreme cases are being made:

-- An attorney in St. Louis is trying to get his client, a pregnant inmate, freed on grounds of false imprisonment of the fetus.

-- Anne Cox, coordinator of the Missouri branch of the Religious Coalition for Abortion Rights, says she knows a female rabbi she declines to name who plans to apply for tax exemption for her baby -- retroactive to conception.

-- A Missouri man who is a few months short of 21 is trying to beat the charge of intoxication of a minor, saying that he is actually nine months older than the state says he is -- and thus legally entitled to drink.

-- Two Missouri judges have acquitted 10 protestors who blocked abortion clinics with their bodies. The judges said the protestors were "rescuing people," in the same way they might break into a burning building to rescue a child.

And there are signs that the notion of life from conception is already spreading into case law. On Sept. 21, a circuit judge in Tennessee ruled that seven frozen embryos of a divorced couple were already children and must not be destroyed.

"You'll have 50 standards in the 50 states," Cox complains. "Theologians haven't agreed for centuries on when life begins. But the Missouri state Legislature -- in its infinite wisdom -- does."

Amid the rhetoric, bioethicists insist science can shed light on the developing fetus. But what science tells us is subject to interpretation.

Instruments can pick up the embryonic heartbeat at the 18th day, brainwaves on the 40th day. Fetoscopy can see the start of a spinal cord at about two weeks. The fetus can grasp objects and withdraw from noxious stimuli at eight weeks. After 28 weeks, all brain functions are pretty much in place.

Some say viability -- the point at which a fetus can live outside the womb -- is the starting point for personhood. That is generally around 20 weeks, when the lungs are sufficiently developed. But viability is actually a practical matter, not a real answer to whether the fetus is a person.

Other experts say the embryo is just a mass of cells before "individuation," when it becomes a distinct unit. For example, it takes up to 24 hours after the sperm penetrates the egg before their genetic packages finish merging. And it can take two weeks for the embryo to lodge in the womb and grow steadily. Before then, it can actually split into twins and recombine. Is it an individual before then?

"It seems appropriate to accord less value to the embryo during the first 24 hours than to a late-term fetus," O'Connell concludes.

Some experts don't even talk about the start of life, however. They say the real question is when a fetus becomes a "person" -- another philosophical morass.

"The cellular life is clearly human -- what else would it be?" says Richard T. Nolan, president of the Litchfield Institute, which has offices in Fort Lauderdale and Connecticut. "The question is when it becomes sufficiently personal to warrant legal and moral protection. And you can take five scientists, or philosophers, or theologians, who will disagree."

Groping for some sort of standards often leads to checklists of characteristics. One bioethicist's list has 15 items, including self- awareness, self-control, a sense of time, a concern for others and "control of one's existence." It would disqualify a lot of adults, not to mention just about every fetus.

Some activists dismiss all of this. Any starting point for personhood, they say, is subjective.

"Personhood is a philosophical concept, not scientific," O'Connell says. "You can pick any point in the fetal development as your starting point. The issue is not what you pick, but why you pick it."

Seizing on the uncertainties of when personhood begins, anti- abortion activists insist on the hard-and-fast biological fact -- human life from conception -- as the point of law.

"A secular state should not choose one religious belief over another," says Dr. John Willke, president of National Right to Life. "But it also should not choose someone's philosophical belief. It should go on the scientific fact of when human life begins."

Even that may not be enough, according to O'Connell, who points out that medical science has redefined death itself. "Before 1981, it used to mean cessation of cardiopulmonary functions. If someone was brain dead but on a heart-lung machine, he was considered alive. Since then, the criteria have included whole-brain death."

-- It is because of the contradictions and the continual redefinitions that bioethicists' cool-headed reasoning -- none of the people interviewed would reveal their positions on when human life begins -- is most needed.

At a convention of the United Church of Christ this past summer, a anti- abortionist started arguing with Patricia Tyson, national head of the Religious Coalition for Abortion Rights. The woman said she had had several abortions, but after becoming a born-again Christian she had become convinced abortion was wrong.

"How can you say you've used safe, legal abortions, then deny that to others?" Tyson asked.

The answer amazed her: "But I was in a crisis. Mine was an emergency."

The Supreme Court barely skirted the issue in the Missouri case, saying it was "not unconstitutional" for the state to say life begins at conception because the legal phrase contains no "enforceable provisions." Referring to "potential human life," the justices added that the state had the right to regulate and limit abortions.

The court's references to "potential human life" bothered J. Robert Nelson, director of the Institute of Religion at the Texas Medical Center in Houston. "The court fouled up. An embryo is not potential life. It's a human life with potential."

Indeed, the very way we talk about the fetus indicates our ambivalence. "How is the baby?" a woman's friends ask as her pregnancy progresses. If she gets into an auto accident, they ask: "Did she lose the baby?" Yet if she miscarries, there is no full- fledged funeral, although friends and family may mourn.

Nor do parents hold a first-year party three months after a child's birth.

And even pro-choicers often caution women against smoking or drinking during pregnancy.

Some philosophers conclude that the fetus has a "conferred value," given by society, rather than an absolute value from God or nature. Frances Kissling, president of Catholics for a Free Choice in Washington, D.C., suggests not a sharp cutoff, but a sliding scale in which the fetus grows steadily in value until it is considered nearly equivalent to a newborn.

She says most women are already "instinctively" adopting this norm because only 10 percent of all abortions occur after the first 12 weeks. In 1973, 75 percent occurred after the first 18 weeks.

The problem is, again, that this sliding scale would let some fetuses live at the same age others would be aborted.

Pro-choice activists insist that the discussion not be limited to the fetus, because it is in the body of a woman who has rights as well -- and who unarguably is a human person.

"Too many people trivialize the issue," Tyson says. "It's not a tooth extraction. It's a serious decision. It should be made with one's family, doctor and religious counselor. But it should not be made by the government."

For Willke, who is convinced the fetus is a tiny human, the decision must be made by government -- for everyone. "Can we continue to solve women's personal problems with the ghastly violence of killing an innocent child?"

Each side predicts victory on the state battleground, of course. One of the more inventive forecasts is that of Dr. Bernard Nathanson, of the Bernadel bioethical think tank in New York. He says a public concept of "prenatality" is emerging, just as the concept of childhood did about 300 years ago. "Before then, children were considered little adults." And perhaps in the future, fetuses will be considered human beings, he says.

-- In the interim it's becoming clear that bioethicists, for all their sophistication, don't have the answers. In fact, they seem to have added several questions of their own.

"This is where there is a disappointment," Nolan acknowledges. "The function of bioethics is to clarify the options of interpretation. I don't see its function as leading people to the Truth, with a capital `T.'"

The question of when human life begins is elusive, then, because it is really a mass of interlocked questions. And if the questions are complex, maybe it's because human beings are complex themselves.

Are we simply bundles of cells? Does our essence come down to the genes that guide our development? Do we have souls and spirits?

The answers might come easily in a nation of one culture, one ethnic group, one religion -- as in Ireland, where abortion is illegal. But not in modern, secular America, where religious people often differ sharply with one another, and with those of no religion.

Yet, once raised, the questions of human life -- when it starts, when it should end, whether it should be aborted -- seem to demand answers. Or failing that, some sort of accord. Some people, including O'Connell, think such agreement is inevitable.

"Whether each side likes it or not, the discussion will be advanced," he says. "And it will push society toward some kind of consensus."

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