Fetal Indications for Therapeutic Abortion

Abstract

There are, of course, those who hold on grounds of personal opinion or individual morality that there are no indications whatever for the early termination of a pregnancy. Their belief teaches that a soul enters the conceptus as the sperm penetrates the egg, and they use such phrases as intrauterine or fetal euthanasia. While all faiths have teachings which differ in some degree on this sub­ ject, the belief that a person is present in the uterus from the moment of conception is exclusively a teaching of contemporary Catholicism, and is not shared by Protestant, Jewish, Mohammedan, Buddhist, etc. For a person of Catholic persuasion, the management of congenital defects is to identify, clas­ sify, and institutionalize the damaged newborn but under no circumstances to prevent such a birth. If such a belief were universal, there would be no need to write the pres­ ent chapter, and the penalty for criminal abortion would be a life sentence for murder rather than a short term for felony. Despite shades of differences among other tenets, in general they hold that an individual is not present until individual existence can be maintained separate from the mother. Ma­ ternally depcndcnt tissue on thc uterine wall is living tissuc, of course (as is the uterus itself ) but it is not a person. In such a view, the early termination of pregnancy is a legitimate thera­ peutic procedure with both maternal and indications. In general, the medical profession has looked upon evidences of defect as being the principal indication for interruption and has indicated a preference for death to defective life. Other factors ( socio-economic status, the wantedness of a baby, etc. ) have generally been grouped with the mater­ nal indications. In our experience at Johns Hopkins in the first two years after the liber­ alization of the Maryland law, indications accounted for less than 2 percent of the total indications; with total repeal, this relative figure would be still lower since presumably the number of abortions for maternal indica­ tions would increase. The American Law Institute's phraseology reads substantial evidence