Wednesday, February 25, 2009

How far should we go to protect "life"?

My personal view of life is that it started several billion years ago, and has been continuing uninterupted ever since. I have never understood the idea that "life begins at conception". Aren't the sperm and egg alive before they merge? And don't they derive from already 'alive' humans? And if you traced back your ancestry, didn't every single person in your lineage start that way -- from already living people? Go back far enough, and you are connected in a very real and ancestral way to those first living things on earth, millions and millions of generations ago.

But there are many for whom "life begins at conception". What they seem to mean is that "humanity" begins at conception, or that the fertilized egg is "fully human" and deserving of all rights and protections as any other person. I wonder -- what could that mean for women and medicine, if taken to it's fullest extent. The following is an hypothetical based on where current technology is, and what the consequences and effects might be if "all abortions" were halted (I'm not just talking about medically induced ones).

Is this the type of situation that you imagined? Do you think such a situation is possible? What other options would you propose to either support or prevent this type of scenario from happening?


While the combination of one sperm and one egg give a unique combination of genes that have the potential to be a full and viable human, that moment is not all that is required. It's estimated that up to 70% of all fertilized eggs fail to implant and are flushed out with the next menstrual cycle (1) -- and the potential mother never realizes it. Additionally, of those that do implant, there is a sizable minority which also spontaneously abort over the course of the pregnancy (additional 10-15%) (2) This means that possibly 80% or more of all fertilized eggs (the majority of which actually successfully implant in the womb) are naturally aborted.

Saying "life begins at conception" implicitly ignores the medical reality that only 20% of those "conceptions" actually have a chance at surviving to birth, irregardless of the number of medically induced abortions. And there is no indication anywhere that all of those 80% naturally aborted were not viable -- on the contrary, it is actually far more likely that a large percentage of them are. They just "miss" the uterine lining and pass out with the next menstrual cycle. Even those that are spontaneously aborted after being implanted and medically confirmed (up to and including the 3rd trimester) are not necessarily "non-viable". Many other conditions and situations can naturally induce a spontaneous abortion -- injury, chemical imbalance, hormonal switching, etc.

So my question to all those who say that conception is the start of human life, and that any abortion after that point (including the "morning after pill") is "immoral", what should we do about all those non-medically induced abortions?

Now that we've got the medical technology to detect fertilization of an egg within 24-72 hours after conception (even before implantation), why should we not try and do everything possible to save them? It may be that some women's bodies are not yet ready to carry a child, but that doesn't mean there isn't a way to monitor the women and collect any and all fertilized eggs and fetuses that are developing. It might be an inconvenience to the women (always wearing monitoring equipment -- or having to go in for testing after each sexual encounter), and the protective regimen to save all those fertilized eggs may be considered by some to be extreme (mandatory bed rest, specially designed monitoring and collection equipment worn at all times to alert doctors and prevent the death of a spontaneously aborted egg or fetus, etc).

I can certainly understand the distaste and concern over medically induced abortions -- but those only account for a small percentage of the potential "lost children" that could be saved.

Consider: There were 4.3 million live births in the USA in 2006 (3) If we add in the full number of medically induced abortions (assuming that 100% of those would have been viable and brought to full term) - approximately 1.2 million in 2006 (4) that brings the number of babies to 5.5 million. But wait -- that's only 20% of the total potential births -- because that doesn't count in the 80% that are spontaneously aborted. Even if we assume that half of the spontaneously aborted would be non-viable (genetic malformation, etc), that still leaves a full 40% of the total conceptions that are allowed to die. That's an additional 11 million potential babies that are naturally lost, and through modern medical technology could potentially be saved.

Of course, implementing this to the full extent of medical technology would mean that every female who begins menstruating would require monitoring (either actively via portable hormone monitoring equipment or through regular weekly visits to a doctor) and surveillance. If a fertilization event is detected, the female would need to either have a full-time monitor carried with her (possibly along with a device that could "catch" any spontaneously aborted egg/fetus and protect it -- I'll let your imagination go to work on that idea), or agree to be examined daily by a doctor after positive confirmation of implantation. Once beyond the second trimester, the risk of spontaneous abortion drops, but not completely. Monitoring and surveillance would still be needed, but only once or twice a week. If at any time, signs of a potential spontaneous abortion are detected, the female should be immediately put into a medically supervised environment and maintained on strict bed-rest to ensure the safety and survivability of the fetus. Only after reaching 24 weeks of gestation would the female be released from the facility - but only with continuous monitoring to ensure the safety of the fetus.

This plan would ensure not only the prevention of all medically induced abortions, but would potentially save millions more who would otherwise die due to spontaneous abortion. If every fertilized egg is "fully human" and deserving of all the rights of humanity, and if we have the medical technology to detect fertilization, monitor implantation and gestation, and either prevent spontaneous abortion or safely collect and re-implant those that do -- shouldn't we make the attempt?



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