High-Tech Medicine Adds to Quandaries in Abortion Debate
Technology used to save premature babies might also be used to save fetuses that have been aborted, but scientists and bioethicists question whether abortion laws should be changed to reflect the scientific advances.
“One of my concerns, looking at the new technology with regard to abortion, is that it is just part of the balancing act in an emotionally charged issue,” said Joyce Bermel of the Hastings Center Report, a journal of bioethics.
“Ninety percent of all abortions are performed in the first trimester (first 12 weeks of pregnancy), and none of these fetuses could be saved” even with the newest in technology, she said.
But the 9% of abortions performed during the second trimester “trouble a lot of people because of the lowering age of viability,” she said.
Fetuses Have Survived
On rare occasions, she said, fetuses have survived abortions in the second trimester--the earliest viability point at which a fetus is able to survive outside of the womb, with the aid of technology.
Doctors estimate that 24 weeks of gestation (six months) may be the lowest point of fetal development when technological procedures might help sustain a life outside of the womb.
The 24-week gestation point is also the legally imposed limit on when an abortion may be performed on demand and unregulated by the state.
Techniques aimed at saving wanted fetuses--at the same age of development as some aborted fetuses--include urinary tract surgery, injection of red blood cells and correction of irregular heart beats.
Expensive Technology
“The technology is very expensive and should be used to save babies in families that want them,” said Atlanta lawyer Margie Pitts-Haymes, who argued Doe vs. Bolton, one of two cases that resulted in the legalization of abortion in 1973.
She doubts, however, that lowering the age of fetal viability will lower the age of development at which a fetus may be aborted legally.
Dr. Michael Harrison, a pioneer in fetal surgery at the University of California, San Francisco, said surgical and medical procedures used to treat illnesses in the womb may be of little value, however, in saving the aborted who survive.
“There are techniques, but I don’t think they would work in those cases. None of the systems are mature. I would expect a high rate of loss and a high rate of damage,” he said.
He said a fetuses’ organs are so immature before 36 weeks of development that heroic efforts--often in vain--would have to be used.
But new medical technology aimed at improving fetal life has been gaining significantly over the last five years, changing the way some people plan their families.
‘Selective Abortion’
In 1981, doctors at New York’s Mount Sinai School of Medicine reported on the first case of “selective abortion.”
When doctors detected that one of a pair of fetal twins was a victim of Down’s syndrome, a genetic defect that causes retardation, the parents urged abortion of one fetus.
Doctors withdrew blood from the heart of the affected fetus and ended its life; the other one was born healthy.
San Francisco doctors foreseeing major developments in fetal intervention called for establishment by the American Medical Assn. of an ethical review board to oversee new procedures and establish guidelines.
“The new medical and scientific knowledge raised my uneasiness a notch or two and has made me all the more insistent that the pro-choice perspective find room for an open airing,” bioethicist Dan Callahan wrote in a recent issue of the Hastings Center report.
He said that he considers himself “pro-choice” on the abortion issue and that changes in technology should not influence when abortions should be performed.
