AFTER hearing numerous submissions on the issue, the Parliamentary Committee examining the recommendations by the Abortion Policy Review Advisory Group has taken a hiatus to consider the matter. Their deliberation is simple: Should the formulation of public policy on the matter be determined by the deeply divided arguments regarding the moral status of a fertilised egg, or on a consequentialistic platform where the current harmful effects of so-called “back-street abortions” need to be reduced or eliminated? Damage to pregnant women who seek the termination of their pregnancies from untrained persons or in unhygienic surroundings may seriously impair their abilities for future reproduction or may even result in their death.

The lobby by some groups for the maintenance of the prohibition against termination of pregnancy has been based mainly on their belief that a fertilised human egg is human life and so deserves the same respect (moral status) as a human being. The groups are not homologous, however, as some religious denominations oppose, while others support the recommendations by the Abortion Policy Review Advisory Group. Persons in support of the recommendations argue from a number of standpoints. Firstly, that women — whose wombs are required for growing the embryo and foetus — must have a “say” in regard to carrying the pregnancy to term (a right to their reproductive health). Further, that whilst a fertilised human egg has a human genetic code (the potential to grow into a human being), it does not have the necessary attributes of a human person (eg having differentiated organ tissues, having been born, having a concept of self, being viable outside the womb, having the capacity to feel pain, and so on). Thirdly, given Jamaica’s current environment, issues surrounding a pregnancy cannot be solely “foetus-centred” in arguments for or against — to the exclusion of the mother or father — but must be considered in relation to other issues, such as its effects on the health and well-being of the mother, sexual coercion, effects on the family, subsequent love and nurturing support, and so on.

I am also hereby proposing that if persons regard terminating pregnancies during the early days of the development of a fertilised human egg as being equivalent to killing a human being, then they must likewise oppose the throwing away of all forms of human life, including hydatidiform moles (pseudo-embryos).

The human development process occurs along a fairly smooth continuum (see figure 1).

On this continuum, once born, every human individual of whatever age and condition merits the same respect for their fundamental right to life.

However, there is also a continuum that represents embryos and other masses of human cells that have varying degrees of organisation (see figure 2).

Hence, the organisation of human embryos, like the developmental potential of different embryos, can vary across a fairly smooth continuum of different cases. Whilst typical embryos at the end of the spectrum have a particularly high degree of organisation of their cells, the entities to the left have less. Hydatidiform moles (sometimes found in women thought to be carrying “normal” pregnancies) have 46 paternal chromosomes rather than the normal 23, and they develop into a disorganised mass of placenta-like structures. Adult stem cells do not currently display much potential for development toward a mature human form, but could be induced (in the right environment) to display some degree of developmental potential or organisation.

Based on the foregoing, therefore, with the varying degrees of organisation existing and varying potential to develop into a human being, what is the “cut-off point”, what level of organisation is acceptable to deny or ascribe moral worth as a human person rather than as human cell masses?

Although many Jamaicans would be unfamiliar with the term “full moral status”, if they were asked the simple question: “When does a ‘person’ begin, is it at fertilisation/conception, when brain waves (brain activity) begin, at viability (able to live outside a mother’s womb), or at birth? — you know which choice would get the lowest response. The fertilised human egg is certainly a member of the human species, but does it suddenly become a “person” at fertilisation?

Jamaicans are divided in their belief systems on this matter. Some believe that human embryos are valuable only “instrumentally” — that is, due to their “potential” to grow into human beings — while others believe that the human embryo is “intrinsically” valuable from the moment of conception. The latter view, however, has a particular religious or metaphysical foundation that is not universally accepted, particularly in pluralistic societies such as ours. Human rights are supposed to be universal in their application, valid for all human beings regardless of religion, race, gender, and so on, and so claims that are founded on a single theological or philosophical view of human nature will be problematic in application for all persons, and unfair if imposed on those who do not subscribe to such a world view. Humans disagree about what types of being they are and what makes them special. Therefore, to take any single religious or philosophical view and use it as the foundation of a universal doctrine will not only negate its universality, but also render it illegitimate in the eyes of many of those to whom it is supposed to apply.

Further, does it matter if the conception occurs through “nature” — the act of procreation (sexual intercourse) or artificially in a Petri dish? If the sperm (human life) meets the egg (human life) in a fertility lab rather than in the Fallopian tubes, is there a moral difference?

If both “nature” and human interference (artificial insemination to produce a pregnancy) are morally acceptable, then shouldn’t “nature” in terminating a pregnancy (33-50 per cent of all pregnancies are lost in the first three months of pregnancy due to developmental aberrations and genetic abnormalities) and human interference in terminating a pregnancy be equally acceptable? The doubt of any great moral distinction existing between the two scenarios is illustrated by the differing positions taken by religious groups (in support of and against) in their submissions to the Parliamentary Committee.

The foregoing examples collectively illustrate the nebulous nature of using the sanctity-of-life principle and ascribing it at the point of conception, then declaring thereafter that any termination of the conception is tantamount to “murder”. And so, where principles and personal beliefs are in conflict, our parliamentarians ought not to be arbiters between the different belief systems (which is the realm for personal advocacy), but must make their decisions of public policy based on consequentialist deliberations, the consequences for society of maintaining the current status quo (where historically numerous terminations of pregnancy occur for various reasons despite the taboo and punitive laws), or implementing the recommendations by the Abortion Policy Review Advisory Group to facilitate proper hygienic conditions and reduce harm for those women exercising their reproductive choice in one way or another.

Dr Derrick Aarons MD, PhD, is a Consultant Bioethicist/Family Physician who provides detailed advice in ethical quandaries.