Autonomy of violence

Bobby Schindler articulates a view of autonomy that he and I have been talking through for a while, which is that an “autonomy of violence” and self-harm pervades life and ethics issues. He writes in CatholicPhilly.com about this, and includes a survey of practical examples around the world that’s worth looking over if you’re not familiar with what’s happening:

Attacks on autonomy and human dignity appear to be intensifying.

Autonomy, of course, refers to our ability to act as independent human beings, with an innate and inviolable human dignity inherent to each of us, regardless of our physical, medical, emotional, psychological, or financial circumstances.

It seems as if so many, however, are intent on reconsidering autonomy to mean something like an “autonomy of self-harm.” In other words, many are using autonomy as a means to advocate for forms of euthanasia and assisted suicide.

Yet autonomy has traditionally referred to human good; our ability and desire as well as power to achieve a good life in cooperation with our loved ones, neighbors, fellow citizens, and others. It’s a tragic and perverse situation to use autonomy as a rhetorical battering ram for advocating the rights of human beings to intentionally end their own lives.

As so much of our attention is focused on dramas of the political arena, stories which ought to be receiving attention are simply not. Certainly, meaningful public dialogue surrounding issues like autonomy and human dignity are not taking place in any sustained manner. …

Autonomy means nothing if we allow laws or medical perspectives to compromise the innate and inviolate human dignity each person possesses, regardless of their state of health. When someone is encouraged to accept euthanasia or assisted suicide, and even worse, when individuals are forcibly euthanized against their will or without consent, the power of law and medicine become weapons rather than shields.

No humane society can accept the normalization of intentional human killing.

In practice, we’re too often favoring a simplistic “might makes right” sort of ethics when it comes to life and death issues, where autonomy exists in a limited way—enabling a sort of “autonomy of the powerful” to impose themselves and their judgments on comparatively weaker persons.

The same thing, with white gloves

I missed the initial report last month when Pope Francis spoke bluntly about the use of abortion as a eugenic instrument:

Pope Francis on Saturday called the practice of having an abortion after pre-natal tests have discovered possible birth defects a version of Nazi attempts to create a pure race by eliminating the weakest.

Francis made the comparison in a long, off-the-cuff address to a members of a confederation of Italian family associations.

“Children should be accepted as they come, as God sends them, as God allows, even if at times they are sick,” he said.

Francis then spoke of pre-natal tests to determine if a fetus has any illnesses or malformations.

“The first proposal, in that case, is ‘Should we get rid of it’? The killing of children. And to have a more tranquil life, an innocent is done away with,” he said.

“I say it with pain. In the last century the whole world was scandalized by what the Nazis did to pursue the pureness of the race. Today, we are doing the same thing, with white gloves.”

Under Nazi eugenics programs, hundreds of thousands of people were forcibly sterilized and tens of thousands killed in an attempt to “clean” the chain of heredity of those with physical or cognitive disabilities.

Good for Pope Francis for speaking so clearly on this. Our individualistic, autonomy-cherishing, consumerist attitudes need these sort of gut-checks.

If we’re going to accept the logic that we can eliminate developing human persons due to predicted characteristics or disabilities, it’s hard to understand why we shouldn’t also accept Peter Singer’s logic that we should be able to eliminate born-but-undesired or born-but-ailing human persons for the same reasons.

And that would lead, certainly, to a freer and more autonomous society, but it would also be a liberty obtained by the strong at the expense of the weak in a society wherein no one’s rights are ultimately secure.

To Vita Institute

I’m in Charlotte right now on a layover, headed to Notre Dame for the next week or so. Notre Dame’s Center for Ethics & Culture is hosting its Vita Institute, which I’ll be a participant in this year. I attended Vita Institute’s New York one day seminar earlier this year, and that made participation in the full program attractive:

The Notre Dame Vita Institute is an intensive interdisciplinary training program for leaders in the national and international pro-life movement. Through engagement with our premier faculty, interaction with other pro-life leaders, and exposure to award-winning community outreach programs, the Vita Institute aims to further enhance participants’ expertise and prepare them to be even more effective advocates on behalf of the unborn.

Held for a week every summer on Notre Dame’s beautiful campus, this program is wholly unique: it provides participants with the opportunity to study the fundamentals of life issues with world-renowned scholars across a wide range of disciplines, including social science, biology, philosophy, theology, law, communication, and counseling. Lecture topics include:

  • The Personhood Debate in Contemporary Philosophy
  • Abortion Jurisprudence
  • Basic Human Embryology
  • Dos and Don’ts of Public Policy on Human Life
  • Helping the Abortion-Minded Woman Choose Life
  • Legislative Strategies for the Current Decade and Beyond

It’s often pointed out that the “right to life” is the right that makes every subsequent right possible. As a culture, we should be doing everything we can to support mothers and fathers facing unexpected pregnancies as much as we provide meaningful care for the aging, elderly, and disabled, and everyone in between through better community life and better social and political responses to crisis.

The promotion of suicide as a good and legitimate response to old age’s feelings of loneliness or doubt about the meaning of life as one’s abilities fade is particularly tragic to me. We celebrated Dr. David Goodall’s recent suicide and mourned and lamented Anthony Bourdain’s within the span of four weeks, all the while ignoring the essential questions of meaning, purpose, and appropriate responses to psychological distress that certainly impacted both decisions.

As long as we perpetuate violence against human life in the name of “autonomy” or “self-actualization” or “health and wellbeing,” we’re falling short of our ideals as a people—and worse, we’re lying to ourselves about the nature of what we tolerate in the pursuit of those ideals.

These are some of the reasons I’m eager to spend the next week participating in this year’s Vita Institute. I might share some of that experience, and will at least share some scenes from Notre Dame and South Bend along the way.

Pursuing what seems good

Ireland has voted to repeal the 8th Amendment to its constitution, which was passed in September 1983 to strengthen its existing law to “recognise the equal right to life of the mother and the unborn.” The specific language:

The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.

In practice, this amendment was designed to ensure that the principle of equality of human life was recognized at the highest level, and wouldn’t be threatened by judicial or legislative actions. In practice, this meant abortion was permitted only in situations where a mother’s life was in jeopardy. The language above recognizing basic equality passed in 1983 with 67 percent of the vote, and the rejection of basic equality just passed with what looks like 67 percent of the vote. The Save the 8th campaigners on the referendum result:

The 8th amendment did not create a right to life for the unborn child—it merely acknowledged that such a right exists, has always existed, and will always exist.

What Irish voters did yesterday is a tragedy of historic proportions. However, a wrong does not become right simply because a majority support it.

We are so proud of all of those who stood with us in this campaign—our supporters, our donors, our families, and our loved ones. This campaign took a huge personal toll on all of us who were involved, and we have been so grateful for their support.

The unborn child no longer has a right to life recognised by the Irish state. Shortly, legislation will be introduced that will allow babies to be killed in our country. We will oppose that legislation. If and when abortion clinics are opened in Ireland, because of the inability of the Government to keep their promise about a GP led service, we will oppose that as well. Every time an unborn child has his or her life ended in Ireland, we will oppose that, and make our voices known.

Abortion was wrong yesterday. It remains wrong today. The constitution has changed, but the facts have not.

We naturally pursue what we believe is the good, so Ireland’s swing on this particular issue in the space of a quarter century, as it related to what its people define as “the good”, is incredible. It suggests, to me, a continuing triumph of a particular sort of libertarianism, and probably continuing problems in Western nations as people try to sort out whether justice is ultimately a contingent and relative thing, or whether any universal or natural justice exists that reason and law should endorse.

Not choice, but violence

Who are the victims of suicide? There are the persons themselves, who die by their own hand or by instructions to other hands in the case of so-called assisted suicide. They are certainly victims. But what about every person touched by the person who is lost? All these are victims, too. Jason Cipriani shares:

I delivered the speech with confidence, but I did get choked up as the words my mother told me that day came out of my own lips “your dad killed himself this morning.” And again as I talked about turning to my grandma on that day, seeing her completely broken down (something that never happened), hearing her say “I’m really sorry boys. I know exactly what you feel, my mom took her own life as well.” …

A few days later I received my critique sheet which included helpful tips and pointers on improving my public speaking skill set, along with a grade. I don’t remember my grade, I don’t remember one critique listed on that piece of paper. The only thing I remember seeing was “I am a victim of suicide, too. I’m sorry for your loss.”

A victim of suicide? Huh. I’m not the victim, my dad was… wait. I am a victim. I have to deal with the emotional scars created by my dad’s decision for the rest of my life.

Those words and the change in perspective they brought regarding my father’s suicide have changed my entire outlook on life. As silly as that sounds. …

I guess, really, it gave me a title. It gave my emotions, my pain, my hurt, my anger, my sadness, my years of depression growing up.. it gave it all a title. You know how people that are chronically sick without a diagnosis feel relief when a doctor is finally able to identify the diseases attacking their body? I can only guess I felt the same way.

After Michael Novak died, Elizabeth Bruenig shared something he said to her a few weeks prior: “A kind word not spoken takes something out of the fabric of what should’ve been.” A life not lived, but willfully concluded, takes something out of the fabric of what should’ve been for every person who knew them, and many who would have. It is a scandal that journalists and media who are too ready to share the desires of euthanasia and assisted suicide advocates do not hold their feet to the fire on the true nature of what they’re promoting. Not choice, but violence.

French Catholic dialogue

It seems likely that France will make at least some forms of euthanasia and suicide legal later this year, which is why President Macron’s explicit invitation to Catholics to participate in the French public debate on bioethics leaves me feeling conflicted:

French President Emmanuel Macron stressed the importance of a Catholic voice in the country’s political debates, particularly on bioethical issues, in an address to the French bishops April 9.

“What I want to call you tonight is to engage politically in our national debate and in our European debate because your faith is part of the commitment that this debate needs,” Macron told French bishops in a rare public meeting between Church and government leaders in France.

While France was once referred to as the “eldest daughter of the Church,” the country’s legal secularism has required strict neutrality of the state in religious matters since 1905.

In his speech Monday, however, Macron spoke of the important philosophical need for the Church’s voice.

“What strikes our country … is not only the economic crisis, it is relativism; it is even nihilism,” said Macron.

“Our contemporaries need, whether they believe or do not believe, to hear from another perspective on man than the material perspective,” he continued, “They need to quench another thirst, which is a thirst for absolute. It is not a question here of conversion, but of a voice which, with others, still dares to speak of man as a living spirit.”

Father Joseph Koczera, an American priest based in Paris, told CNA that in some ways, Macron’s speech “was quite remarkable.”

“This is a clear challenge to a particular style of French secularism that suggests that, [since] the state must remain neutral, perspectives informed by religion should not be invoked in political debates,” Koczera said.

Macron stressed that “Secularism does not have the function of uprooting from our societies the spirituality that nourishes so many of our fellow citizens.”

“To deliberately blind myself to the spiritual dimension that Catholics invest in their moral, intellectual, family, professional, social life would be to condemn me to having only a partial view of France; it would be to ignore the country, its history, its citizens; and affecting indifference, I would derogate from my mission,” he said.

Macron’s speech comes as bioethical debates continue in France, with parliament preparing to reform its bioethics laws.

It’s a great thing that President Macron is inviting Catholics back to a place in public discourse. But if it ends up merely being a further way to condone an anticipated legalization of forms of euthanasia and suicide by underscoring that “Catholics were given a chance to voice their positions,” after all meaningful decisions had already been made, then it would be an example of cynical political use, rather than meaningful outreach and dialogue. We’ll see.

What Newsweek knew

There’s this debate in America, or what I think is often a sort of pretend debate, about the moral status of the human life that’s in the womb of a pregnant woman. That is, about what precise it is that a woman is pregnant with.

We’re left with two troublesome factions in American life, neither of which do a good enough job stating what they’re after, but one of which tends to purposely confuse in its use of language by making an issue that is obviously about the value of human life into a question of the choice of the strong triumphing over the contextually weak.

The common sense civic debate Americans should be having, which boils down to how one of the wealthiest and most privileged societies in human history should be creating a wide and broad social safety net to ensure that no unexpectedly pregnant woman is encouraged to abort her child because we’re able to provide her with a continuum of care that ensures her life is not “over” due to that child—from incredible welfare benefits to education/workforce training, to child stipends until the child is of a certain age, to housing, etc. But we don’t have that conversation, and that’s largely a scandal and fault of Planned Parenthood and other “choice” advocates who in practice offer only one choice: abortion. They receive more than a billion in public funding annually, and pro-choice attitudes dominate in the media, and yet they’re not using their power and influence to broaden the public debate about the range of options that should be offered to pregnant woman. At minimum, that’s a failure of imagination.

And in the meantime, Americans sometimes debate about what exactly is in the womb. Is it a person deserving of legal protections our constitution claims to offer? Or does is have a lesser moral or legal status? Are 20 week limits on abortion, when we believe the creature can feel pain, for instance, extreme? That’s what we’re debating today.

The development of 4D ultrasound, and of modern medical technologies, help us see into the womb in ways that were impossible when Roe v. Wade was decided. We know more today than Americans could have then. That’s what I grew up hearing.

Yet here’s what Newsweek featured on its cover in 1975:

1975-03 Newsweek Cover

That’s a human life at four months. And it was featured on the cover of a major news magazine months after Roe v. Wade was handed down. Do we know less in 2018 than what Newsweek knew in 1975? We know what’s in the womb, and it seems like we’ve always known. Psychologically, biologically, scientifically we know what abortion does. The questions are all political and cultural and social.

Why we don’t at least mandate that Planned Parenthood be funded to aggressively promote adoption and women’s education and workforce training and childhood stipends, etc. as much as it does abortion is anyone’s guess.

‘Living Wills’ should foster a patient’s will to live

Bobby Schindler and I write at National Catholic Register on Italy’s recent adoption of Advance Directives, or “Living Wills”:

Advance Directives, to the extent that they enable a mentally and physically competent person to outline their authentic and life-affirming medical wishes in advance of situations where their judgement may be compromised, can be good and useful instruments for ensuring that health care be life-affirming and not needlessly extraordinary in nature. What makes Italy’s Advance Directive law so troublesome is its embrace of a euthanasia logic that permits, or even encourages, patients to fatally deny themselves food and water, and further its aggression and violence against the conscience rights of physicians and health care workers whose right to dissent is not recognized. Every one of those more than 700 physicians who appealed for Eluana’s right to basic treatment may one day be forced to choose between intentionally bringing about the death of another Eluana, on the one hand, or being branded an extremist and consequently forced out of medicine, on the other.

Whether one is Catholic, or Protestant, or secular and unreligious, it represents a distortion of medicine’s purpose to conflate Advance Directives and the principle of medical planning with the ability to self-deny or to be denied food and water, which represents neither a costly nor an exotic form of care.

At the true end of life, the human body becomes incapable of metabolizing food and water, which is ultimately why the issue of “food and water” – as if it were an “end of life” issue by its nature – is disingenuous. Characterizing food and water as necessarily an “end of life” issue is a distortion of the reality facing millions of persons reliant on feeding tubes throughout the world each year. A young and recovering alcoholic, for instance, may be reliant on food and water by feeding tube for many months, or even years. In no traditional sense would this person be facing a fundamentally “end of life” issue, yet legislation like Italy’s encourages both the public and the patient to consider such situations in a much more fatalistic way—in a way almost certain to degrade a vulnerable patient’s will to live.

In societies that still officially oppose suicide and recognize the need to offer crisis counseling and emergency support to men and women captured by often fleeting moments of suicidal thinking, we should take the same approach of offering life-affirming care to medically vulnerable patients. Indeed, the daily lives of vulnerable patients may in fact be more consistently grinding on their will to live, especially in cultures like Italy’s whose law now rhetorically implies questions like, “Why not put a permanent end to anxiety? To periodic suffering? To moments of discomfort? To the need for rehabilitation?”

Italy’s parliament should do better by allowing for advance directive planning that fosters a will to live among vulnerable patients, continues to proscribe intentional life-taking, and cultivates life-affirming clinical environments where the conscience rights of physicians and health care workers are paramount in service of medicine’s basic purpose to cure, heal and comfort.

Read the entire piece.

Latvian and Nazi abortion policies

A follow on to yesterday’s look at Germain Grisez’s historical portrait of Soviet abortion policy in his 1970 book “Abortion: The Myths, The Realities, and the Arguments“. This shorter excerpt focuses on Latvian abortion policy inspired by the Soviets, but which introduced a new and non-therapeutic, non-medical basis for abortion based on characteristics and class status.

The Nazis later built upon the “characteristics and class” approach to abortion policy as a means to realize their vision of a “purified master race.” A Nazi innovation in this regard was likely the first-ever justification for abortion based on the “viability of the fetus”:

Between 1920 and 1936 the Soviet experiment was followed with interest by observers in other countries. The legalization of abortion in many places became a political issue; radical legislators now saw this measure as an integral part of socialization. In some places new laws were passed, but non of them were as radical as the Soviet decree of 1920. All embodied a compromise: abortion became legal in certain kinds of cases and in accord with other definite requirements.

Latvia, then an independent republic bordering on the U.S.S.R., apparently was the First Nation to pass such a compromise abortion law. The act, passed December 30, 1932, provided that any attempt to procure abortion against the pregnant woman’s wish remained illegal. But a physician inducing abortion to prevent loss of light or serious damage to health of the prospective mother was not regarded as criminal. These two provisions incorporated the principle of the woman’s wish—in a negative way, by requiring her consent—and the principle of therapeutic abortion, which in almost every country was accepted in practice.

But then the law went on to provide that abortion would not be illegal if:

  1. It were performed during the first three months of pregnancy;
  2. With the woman’s consent;
  3. By a physician;
  4. To prevent one of the following: (a) The birth of a child having a physician or mental defect (the “eugenic” indication); (b) The birth of a child conceived in virtue of certain proscribed acts—seduction, rape, incest, and criminal assault (the “humanitarian” indication); (c) The birth of a child that would cause privation to the pregnant woman or her family (the “social” indication).

In these provisions the Latvian law accepted the principle of abortion as a method of birth prevention where there were serious indications of a “eugenic,” “humanitarian,” or “social” kind.

We shall see much discussion of these indications in subsequent debates. The essential point is to notice that they represent a principle distinct from therapeutic abortion. In therapeutic abortion the objective is not to prevent the birth of the child, although in fact the child is aborted for the mother’s benefit. In the compromise legislation of which we see a model in the Latvian act of 1932, the purpose of the indicated and permitted non-therapeutic abortion precisely is to prevent the birth of children falling into certain classes. Insofar as abortion is admitted as a method of birth prevention the principle of the Soviet law is accepted. However, insofar as specific indications are required, a new principle, derived neither from the traditional view nor from Soviet theory, is operative.

Information about the success of the Latvian compromise is not easily had. The original law was amended by an act of March 22, 1935, which eliminated the “social” indication and tightened up conditions under which most physicians could induce abortion. Under the 1935 amendment only gynecologists and physicians especially appointed by the state were allowed to perform the operation outside a hospital or clinic.

One of the bitterest battles concerning abortion law relaxation was fought in Germany between 1920-1933. Proponents of a relaxed law did not succeed in winning official acceptance for their position until the Nazis came to power. Then the Law for the Prevention of Hereditary Diseases in Posterity, 1933, was passed (amended 1935).

Under this law, a pregnant woman selected for sterilization might also be aborted provided she consented, if there were no medical contraindications and if the fetus were not already viable.

Also under this law, a physician might induce abortion (as well as sterilize a woman) to avert serious danger to a woman’s life or health. In this case also the woman’s consent was required. Except in emergency cases, each operation had to be reviewed in advance by a court of referees, which consisted of medical practitioners. The abortionist and the review court of referees were supposed to be independent of one another both in judgment and in action. All induced and spontaneous abortions were to be reported to the Medical Officer of Health.

At first glance it might seem that the Nazi legalization of abortion was minimal. To begin with, the law required the woman’s consent—abortion was voluntary, not imposed. However, William Russell, a member of the American diplomatic corps in Berlin prior to World War II, wrote:

“The Nazis laid great stress on the fact that everything the nation did at their command was ‘voluntary.’ Even the compulsory two-year period of service in the army is ‘voluntary.’ Every boy is required by law to serve, so the Nazis call it volunteering. I have no doubt but that even those unfortunates who were slaughtered in the 1934 purge died ‘voluntarily.'”

The essence of the Nazi law was not, then, that it required the woman’s consent. One distinctive feature of this law was the fact that it used the viability of the fetus as a significant dividing line. So far as I know, this was the first law to use this criterion, and thus many current proponents of abortion law relaxation follow in the Nazis’ footsteps at least to this extent.

The Nazi law fit into the National Socialist outlook just as the Soviet law fit into the Communist outlook. The Soviets liberated women from traditional morality in order to use her in the work of the triumphant social-economic revolution. But the Nazis aimed at quality—the reign of the supermen—the purified master race. Thus their program depended upon getting rid of weak and inferior specimens, while keeping the stronger and purer ones. Of course, the Soviet decree of 1936 adopted a position on abortion not far different from that which the Nazis had put into effect in 1933.

So far as we know, however, the Soviet program never led to the consequences that developed in Germany. There the program of selective sterilization and abortion was developed by the medical men themselves into a large-scale program of “euthanasia”—that is, murder of mental patients and others, even German soldiers mutilated in the war. The euthanasia program blazed the trail for the even more extensive mass murders of Jews, gypsies, and other so-called “contaminants of Aryan purity.”

Thousands of German, non-Jewish children were disposed of in the euthanasia program, many for a social reason rather than because of any inherent defect. This murderous project was not initiated by Nazi officials but by the medical profession itself; in fact, no law ever gave it formal sanction. Killings were done under the supervision and by the direct acts of psychiatrists and pediatricians. Euthanasia murders were passed upon by independent medical consulting boards, similar to those required in the 1933 act to approve abortion. The murders of the children were accomplished mainly by starvation or by overdoses of drugs. But this project did not end until allied troops overran the institutions concerned, and as time passed the infants became older and the indications slimmer—for example, “badly modeled ears,” bed wetters, and children “difficult to educate.”

Certainly one cannot say that the Nazi sterilization and abortion law would have led to these consequences if the Nazi regime had not been what it was as a whole. On the other hand, one cannot dismiss the whole affair as mere Nazi insanity. The vast majority of participants in the affair were no less sane and no less upright than the members of any modern nation’s medical profession.

The roots of the euthanasia program actually antedate the rise of Hitler. In 1920, a physician and a lawyer—Alfred Hoche and Karl Binding, both prominent men in their fields—published a very influential little book: The Release of the Destruction of Life Without Value. The principle of their position was that some human beings are worthless and must be killed for the sake of quality of life.

Thus leading members of the medical profession were quite prepared by 1933 to put into effect the Nazi program of selective sterilization and abortion, and this same medical profession itself organized and pushed ahead the euthanasia program of the late 1930s which merged into the genocide program of 1941-1945. Some physicians did refuse to cooperate in the “euthanasia” murders and they were not punished for their refusal.

What is the human person? Where does our unalienable dignity find its source? Are powerful actors or states able to legitimately alter the basic human right to life? Do we have rights that go deeper than the ever-changing ability of a nation’s law and culture sensibilities suggest?

Is it helpful to imagine all of creation—this world and the wider universe—as essentially a technical-style machine, if the result of that thinking leads to imagining human persons are disposable in the same way that the components of a machine matter less than its overall functioning?

It seems to me that if we are simply concerned with achieving the “greatest good” without examining either what constitutes “the good” or the extent of the costs of achieving that good on every human person, then we are vulnerable to waking up having found that we’ve constructed the latest version of a terribly oppressive society.

Soviet abortion policies

An incredible historical portrait of the Soviet Union’s shifting approaches to abortion comes from Germain Grisez’s 1970 “Abortion: The Myths, The Realities, and the Arguments“. In light of Grisez’s death earlier this month, I’m excerpting a significant portion in the hope that this might increase awareness of his wider body of work among future readers.

In its essence, what was the Soviet approach to abortion? A serious of shifting arguments about human rights, but lacking any cognizance of the most foundational human right to life, that variously loosened, tightened, and somewhat loosened abortion policy based not on any philosophical or other insight into human rights or nature, but almost entirely on the ever-evolving needs of the Soviet state itself:

Abortion Law in the U.S.S.R.

“No book on abortion written today can be complete without special consideration of the movement in Soviet Russia to legalize abortion. The true significance of this unique experiment must be left for future generations to decide. Certainly the present opinion of the majority in other countries is that this movement is in many ways detrimental to the human race. In all fairness, however, a brief review of the measures originally adopted and their modification in subsequent years should be given, with an analysis of the results thus far obtained. In any problem into which social doctrines and religious and anti-religious bias enter so largely, it will be difficult to separate truth from exaggeration.”

Thus Dr. Frederick Taussig opened his chapter on legalized abortion in the Soviet Union in his 1936 treatise on abortion. Writing under sponsorship of the National Committee on Maternal Health, which represented the more venturesome wing of the American birth control movement, Taussig was fascinated by the Soviet Union’s “unique experiment.” Guarding against the influence of “religious and anti-religious bias,” Taussig had gone to Russia in 1930 “to see things at first hand.” Now Taussig was making sure that the benefit of Russia’s example would not be lost to his readers.

Prior to the Communist revolution, abortion was legally forbidden, with no explicit exception even for therapeutic abortion. In the first years after 1917, social turmoil was general. Probably abortion became more widespread in this period. On November 18, 1920 a decree was issued by the Commissariats of Health and Justice legalizing abortion.

The decree begins with a prologue that makes the following points:

—Abortion has been increasing for ten years in Western Europe as well as in the Soviet Union. (The Commissars did not want to put their own people in an unfavorable light, and were seeking support in the argument: “Everyone has the problem.”)

—Legislation punishes the woman and the physician, but this is ineffective, for it drives abortion into the basement and puts women at the mercy of greedy and unskilled abortionists. (This is the public health argument for abortion, with an appeal to sympathy for the woman’s plight.)

—Nearly 50 percent of aborted women suffer infection, and about 4 percent die. (These figures obviously could not be proved.)

—By propaganda and welfare measures the government fights this evil. “But, since the moral survivals of the past and the difficult economic conditions of the present still compel many women to resort to this operation,” the government decided to legalize it. (The “moral survivals” must refer to the reluctance of some women to bear illegitimate children. “”Difficult economic conditions” is a very brief way of expressing an official, restrictive population policy. The government could not provide the required welfare programs. Industrialization was more urgent, and a limited increase of population would assist economic transformation.)

The degree itself was simple. Abortions were permitted without charge in Soviet hospitals. Only physicians might induce abortion. Others, and physicians inducing abortion in private practice, were subject to trial by a People’s Court.

To understand fully the sense of this decree concerning abortion, it is important to know that the Soviet revolution also “emancipated women.” Sex differences were so far as possible disregarded for social and economic purposes. The rule was equal pay for equal work, and women worked in occupations such as mining and seafaring hitherto reserved to men.

Women also received equal education and equality of status in marriage itself. Divorce and marriage were made into easy formalities, and either partner had equal rights to determine place of residence and to hold and dispose of property. Sexual inhibitions were eliminated and sex lost much of its romance. One observer noted: “Chastity is admirable, but a girl who ‘slips,’ and still more a boy, is regarded as merely foolish.”

Abortion legalization thus filled three functions. First, as a public health measure, it aimed at eliminating illegal abortion. Second, as a matter of economic policy, it was aimed at population control. Third, as a legal matter, removal of criminal penalties contributed to the “emancipation” of women.

The legalization of abortion naturally led to a very rapid increase in the numbers of such operations in hospitals. In 1922 in Moscow there were 35,520 births and 7,769 abortions; by 1929 there were about eleven times as many abortions, 82,017, while births increased only to 51,059. Thus there were far more abortions than births, though the number of births actually increased.

The rapid increase in abortions caused problems with hospital administration. Some effects to curb abortion administratively were made as early as 1924; later, charged were levied on those who could afford to pay. Special units—abortoria—were set up to perform the operations on a mass production basis; Taussig reported fifty-seven abortions performed by four abortionists in two and one-half hours. Government sources claimed that the experiment was very successful, that the death-rate was very near to zero and the morbidity-rate quite low. In Moscow in 1925 it was claimed there were no fatalities in 11,000 abortions; only about 4 percent of over 50,000 cases showed bad effects. Twelve years after legalization the government statistician claimed that the lives of 300,000 women had been saved by legalizing abortion.

One of the authors of the legalization decree, Commissar of Health N.A. Semanshenko, argued in a 1934 book that the Soviet way was far preferable to the German. In Germany postpartum deaths were far higher and, he claimed, the rate of abortions was twice as high. Thus the Soviet way meant fewer abortions and these done upstairs, not in the “basement” of illegality. The abortions he said were mainly done because of housing shortage, poverty, illness, and large families.

The Soviet statistician Genss pointed out to Dr. Taussig that the birth-rate had been maintained, and argued from this that the rapid increase in hospital abortion only indicated that hitherto criminal operations were now entering hospitals. As Taussig observes, Genns’ own figures do not bear out the claim that the birth-rate had been maintained, although it had not fallen sharply and the population continued to grow during the first decade of legalized abortion.

Taussig, who was not unsympathetic to the Soviet experiment, observed: “In fact, the bulk of the evidence points to an actual as well as an apparent increase in the abortion rate, for in the past five years, during which the number of secret abortions has apparently been stationary, the total number has shown a steady increase.”

Though illegal abortions were fewer under legalization than before, Taussig also noted: “Even so, the evidence from various sources  leads to the conclusion that there are still a considerable number of abortions being done outside the law. It would seem that the very legalization of abortion has led some women to regard more lightly the moral and religious scruples that in the past had restrained them from undertaking such measures.”

Beginning in the late twenties, Stalin’s austerity program dislocated many segments of the population and made living conditions in general harder. One authority has speculated that in the early thirties the abortion-rate must have shot up even beyond that of the twenties, to the point where the population curve became alarming.

Some restrictive efforts were made. In 1927 one Soviet authority called attention to the spread of abortion among the country people and to the danger of depopulation on the farms. He wanted the government to stimulate motherhood. Efforts were made to discourage women from having their first pregnancy aborted. Physicians and social workers tried to dissuade women who could afford a baby from having it aborted. Almost none of the women being aborted was allowed any anesthesia. On the walls of abortoria signs were put up with slogans such as “Let this abortion be the last one.” And specimens of early embryos were displayed in glass jars so that women obtaining abortions would see how quickly development progresses in the early months of pregnancy.

Already in 1927 a meeting of Ukrainian gynecologists reflected hostility toward abortion among the medical profession; one observer regarded this meeting a a demonstration against legal abortion. In the early 1930s Russian medical sources began to report a multitude of serious side-effects—for example, sterility, loss of sexual desire, “pelvic disturbances,” ectopic pregnancies, and “hormone imbalance.”

In 1936 a draft decree was formulated forbidding abortion and “combating light-hearted attitudes toward the family and family obligations.” In an extraordinary procedure, this decree was submitted to the people for discussion before it was officially promulgated; some changes were made on the basis of the discussion and the decree appeared June 27, 1936, as a “Decision of the Central Executive Committee of the U.S.S.R. and of the Council of People’s Commissars of the U.S.S.R.” over the signatures of Kalinin, Molotov, and Unschlicht.

The decree began with a prologue which neatly balanced references to Soviet women’s “emancipation” with references to her “great and responsible duty of giving birth to and bringing up citizens.” A significant paragraphs stated: “Back in 1913, Lenin wrote that class-conscious workers are ‘unquestionable enemies of Neo-Malthusianism, this tendency for the philistine couple, pigeon-brained and selfish, who murmur fearfully: ‘May God help us to keep our own bodies and souls together; as for children, it is best to be without them.'””

Yet pragmatically abortion had to be legalized to avoid worse evils while the last vestiges of exploitation and its consequences were being overcome. Now, the prologue continues, socialism has succeeded so well that welfare measures and provisions for “combating a light-minded attitude toward family and family obligations—such are the roads which must be followed in order to solve this important problem affecting the entire population. In this respect, the Soviet Government responds to numerous statements made by toiling women.”

Thus by popular consent and feminine demand, the law went on to lay out its program. Abortion was forbidden unless the pregnancy threatened the life or seriously threatened the health of the pregnant woman, or when a serious disease of the parents could be inherited. The permitted abortions had to be performed in hospitals or maternity homes by physicians. In other circumstances, both the abortionist and the woman herself were subject to criminal penalty; also anyone compelling a woman to undergo an abortion was to be penalized.

The decree increase state aid to mothers and provided special allowances for large families. Pregnant working women were given special job and income security (an exception to the equal-pay-for-equal-work rule). The network of maternity homes, nurseries, and kindergartens was extended. Authority over kindergartens was somewhat decentralized; they became adjuncts to factories or other places were the mothers would be employed.

Stricter administrative provisions were set down concerning divorce; how restrictive they would be in practice clearly would depend on administrative policy. The father of the children was held to contribute for their support from one-fourth (for one child) up to one-half (for three or more children) of his wages.

An official directive also was published listing medical indications and contra-indications for therapeutic abortion.

The decree prohibiting abortion introduced the prohibition proper with the phrase: “In view of the proven harm of abortions…” This suggests that the medical arguments had been a decisive factor. However, the Ukrainian gynecologists in 1927 had urged the substitution of contraception for abortion, and such a step would have solved many of the medical objections. However, when Margaret Sanger visited Russia in 1934, though she was pleased to see the emancipation of women, she was disappointed to discover that the paper plans for contraception were not resulting in practical programs. Mrs. Sanger asked the Secretary of the Comissariat of Public Health, “Has Russia a population policy, Dr. Kaminsky?” She felt that a country with five-year plans for agriculture and manufacturing should certainly have a birth control program. But the official rejected the idea: “There is no policy as to the question of biological restriction. For six years, we have had a great shortage, not only of skilled workers but of labor in general. Now the only question is the increase of population.”

Thus we see the explanation of the 1936 decree’s reference to Lenin’s remark about neo-Malthusianism. The Soviet policy was not aimed at feminine emancipation nearly so much as at the national interest. The birth control movement took an essentially individualistic and libertarian approach. The Soviet policy was more in the nature of controlling the production of an important economic factor—workers. Legalized abortion in 1920 turned off the population stream to aid industrialization. the prohibition of abortion in 1936, together with the other measures in that decree, turned the stream of population on again.

There are several confirmations that this, in fact, is what happened. As the Kinsey study observes, several sympathetic non-Russian observers suggested “that economic and political motives demanded a cut in abortions so that a higher birth rate could produce a larger labor force and more manpower for a future possible war.” A Russian refugee physician explained that “the government’s intention to increase the birth rate backfired.” Provisions had been made for handling more maternity cases, but many women had illegal abortions instead.

Most important, in 1939 the Soviet ambassador to the United Kingdom answered inquiries from the British medical profession with an official memorandum explaining the Soviet Union’s 1936 decree prohibiting abortions. Most of the memorandum summarizes the explanation given in the decree itself. But two added points concern population. The first notes that the birth-rate has increased since July 27, 1936, but asserts this was mainly due to prosperity and improved health. The final point in the memorandum is this sentence: “Subsidiary reasons for the abolition of the law of 1920 on abortion were to inculcate in the young a greater sense of responsibility both in regard to marriage, the bearing of children, etc., and to raise the birth-rate.”

It is difficult to say how effective the 1936 decree was. We have noticed already the refugee testimony that it “backfired” and the ambassador’s observation that the birth-rate had increased—not, of course, mainly because of the prohibition on abortion. Certainly at the time the draft decree was under public discussion, many who wrote letters published in Izvestia showed that they had adopted the view that abortion was one of an emancipated woman’s rights.

A girl who as a medical student complained of the housing situation and added: “In five years’ time when I am a doctor and have a job and a room I shall have children. But at present I do not want and cannot undertake such a responsibility.” A group of women on a collective farm wrote that conditions under which abortion was permitted should be stated so that physicians could not refuse a patient.

An engineer wrote: “The prohibition of abortion means the compulsory birth of a child to a woman who does not want children. … Where the parents produce a child of their own free will, as is well. But where a child comes into the family against the will of the parents, a grim personal drama will be enacted which will undoubtedly lower the social value of the parents and leave its mark on the child. … To my mind any prohibition on abortion is bound to mutilate many a young life.”

A research worker wrote: “[W]e all want to be ‘working women.’ The tribe of ‘housewives’ is dying out and should, I think, become extinct.”

Despite these attitudes, the 1936 decree was passed and criminal prosecutions of abortionists were carried on under its terms. The continuance of abortion was explained as a residue among the unenlightened of bourgeois consciousness. The Soviet Encyclopedia held that in other countries the poor had abortions through misery, the rich through selfishness. Governments outside the Soviet Union could not fight abortion by improving social conditions, and greedy physicians practicing non-socialized medicine performed abortions as a lucrative part of their practices.

However successful the 1936 decree may have been, a new decree was required. It was issued July 8, 1944, and began as follows:

“The Praesidium of the Supreme Soviet of the U.S.S.R. has issued an edict on increasing state aid to expectant mothers, mothers of large families and unmarried mothers; the protection of motherhood and childhood; and institution of the honorary title of Mother Heroine, the Order of Glory of Motherhood and the Motherhood Medal. The welfare of children and mothers and the consolidation of the family has always been one of the major tasks of the Soviet State.”

The decree explains that war conditions require the extension of state aid. A “Mother Heroine” title goes to women who have had and raised ten or more children; the other honors can be earned in various grades by mothers of somewhat fewer children. The decree also ends the parity between legitimate marriage and de facto unions, makes divorce more difficult, taxes single persons and couples with small families, and orders that certain existing laws—including that prohibiting abortions—be enforced.

In effect, this decree was a measure to step-up population growth in order to make up for war losses and to provide the population input needed for postwar expansion.

But other decisive shift was made November 23, 1955, when the Praesidium of the Supreme Soviet passed another decree: “The Repeal of the Prohibition of Abortions.” The prologue to the decree argues that social and economic progress is so great that a law prohibiting abortion is no longer necessary; the encouragement of motherhood and educational measures are sufficient. Also, the repeal of the law will limit the harm done to women by abortions done outside hospitals. The final reason given was “in order to give women the possibility of deciding by themselves the question of motherhood.”

Thus, as the population input was to be slowed, the old appeal to individual freedom was used as a reason for a shift in public policy. Very little publicity was permitted for the new order, but reports indicated that in many cities abortion outnumbered live births. Some experts estimated that by 1959 the total annual rate of abortions in the U.S.S.R. ran over 5,000,000. In addition, one survey showed 21 percent of all abortions taking place outside hospitals. Many of these were illegal. A report indicated that 40 percent of women students at Moscow University had undergone abortions; a coed told an American visitor the true figure was nearer to 80 percent. Promiscuity was officially frowned upon—but economically desirable for female students, who supplemented small stipends. Abortions at the University clinic cost five rubles—one dollar at the U.S. rate of exchange.

In the population at large, lack of housing, inadequate care facilities, and too many or too close births were the chief reasons given by a sample of 26,000 women having abortions; about one-third of this group, however, simply did not want to have a baby.

We have considered the history of the Soviet Union’s legal provisions concerning abortion at some length. This history is significant because the 1920 law was unique in its time and as we shall see the Soviet experience was a model and inspiration for other efforts to relax the old laws against abortion. The old laws had been based on the inviolability of the life of the unborn child. The Soviet decrees were based on the requirements of society, although individual liberty and medical considerations also were given as reasons, and the latter undoubtedly played some role. The Soviet government’s style of policy-making in disregard of the right of the unborn to life has been perfectly consistent with its style of policy making in disregard of other human rights, including the right to life of persons already born.

Tomorrow I’ll excerpt a much shorter bit of Grisez’s history of Nazi abortion policies from the same historical moment.