Abstract

In recent years, multifetal pregnancy reduction (MFPR) has increasingly been a subject of debate in Norway. The intensity of this debate reached a tentative maximum when the Legislation Department delivered their interpretative statement, Section 2 - Interpretation of the Abortion Act, in 2016 in response to a request from the Ministry of Health (2014) that the Legislation Department consider whether the Abortion Act allows for MFPR of healthy fetuses in multiple pregnancies. The Legislation Department concluded that the current abortion legislation [as of 2016] allows for MFPR subject to the constraints that the law otherwise stipulates. The debate has not subsided, and during autumn 2018 it was further intensified in connection with the Norwegian Christian Democratic "crossroads" policy and signals from the Conservatives to consider removing section 2.3c and to forbid MFPR. Many of the arguments in the MFPR debate are seemingly similar to arguments put forward in the general abortion debate, and an analysis to ascertain what distinguishes MFPR from other abortions has yet to be conducted. The aim of this article is, therefore, to examine whether there is a moral distinction between abortion and MFPR of healthy fetuses. We will cover the typical arguments emerging in the debate in Norway and exemplify them with scholarly articles from the literature. We have dubbed the most important arguments against MFPR that we have identified the harm argument, the slippery-slope argument, the intention argument, the grief argument, the long-term psychological effects for the woman argument, and the sorting argument. We conclude that these arguments do not measure up in terms of demonstrating a morally relevant difference between MFPR of healthy fetuses and other abortions. Our conclusion is, therefore — despite what several discussants seem to think — that there is no morally relevant difference between the two. Therefore, on the same conditions as we allow for abortions, we should also allow MFPR. Keywords: abortion, ethics, medical ethics, MFPR, selective MFPR

Highlights

  • The right to self-determined abortion has been recognised in Norway since 1976 (Abortloven 1976), but it is still a subject of debate (Austveg 2017)

  • Our interpretation is based on the assumption that multifetal pregnancy reduction is carried out so that the selection is random, and that there is no selection between fetuses on a basis other than those which the Abortion Act allows for, ref. 2, section 3, letter c

  • We find no evidence for the proposition that a country with legalised abortion should not allow MFPR on healthy fetuses14

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Summary

Introduction

The right to self-determined abortion has been recognised in Norway since 1976 (Abortloven 1976), but it is still a subject of debate (Austveg 2017). The legislation Department refers to historical documents (NOU1991:6, Ot.prp.35) in their reply and concludes: The Abortion Act allows multifetal pregnancy reduction within the limits the law otherwise stipulates. This means that it is legal to grant multifetal pregnancy reductions on healthy fetuses on the basis of the woman’s health, cf the Abortion Act (medical indication) or on the basis of her situation, ref. Our interpretation is based on the assumption that multifetal pregnancy reduction is carried out so that the selection is random, and that there is no selection between fetuses on a basis other than those which the Abortion Act allows for, ref. 2, section 3, letter c

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