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Why I Became a Pro-Choice Advocate

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There have been a number of arguments raised over the years concerning whether or not a woman should have the right to choose to have an abortion or not.  I’d like to briefly discuss the primary arguments that I’ve personally found to be the most compelling.  Personally, I hold the view that a woman should indeed have the right to choose whether or not to terminate a pregnancy, and thus I am a pro-choice advocate, though this wasn’t always the case (as a former pro-life/anti-choice atheist, and before that a pro-life/anti-choice Christian).  The primary arguments I’m going to discuss will hopefully illustrate why in fact I hold the pro-choice view that I do, and why I believe it is both rational and reasonable for others to share this view as well.

First, when it comes to determining what individual rights we should or shouldn’t have, we must ask if we want to live in a world where we theoretically begin with no rights at all and then add any desirable rights as needed over time, or where we theoretically begin with every possible right and then remove/restrict rights as desired over time.  It seems obvious to me that the first scenario would be simply absurd and wholly impractical to implement.  Among many other reasons to reject this first scenario, we need only realize that if we began with no rights at all, we wouldn’t even have the right to determine or vote on what rights we should be given at some future point in time.  Furthermore, nobody would have the right to enforce any kind of “no-rights” system put into place.  At the very least, to avoid these absurdities and impracticalities, it is easy to see that the second scenario best describes what any rational person would want.  That is, people want to have as many personal liberties and freedoms as possible with the intention of only excluding certain liberties when they contradict other liberties that are more fundamental.  When it comes to determining which rights should be restricted or excluded in a society (and/or which are most fundamental), people also tend to want to accomplish that decision-making through well-informed democratic processes rather than some particular individual or group making the decision and forcing everyone else to abide by such laws.

Why Have Individual Rights in the First Place?

So what exactly is the primary goal of having and protecting any rights for an individual?  I believe the primary goal that most people (if not all) would agree with is the ultimate intention of creating, maintaining, and living in a society that is conducive to the greatest levels of overall satisfaction and well-being of the lives of every member of that society.  From a libertarian perspective, we could also say that this amounts to a goal of minimizing the magnitude and number of situations in which people are forced into doing something that they don’t want to do.  When we consider the topic of abortion, the primary arguments on either side of the issue tend to pertain to determining and defining which specific individual rights exist (or that arguably should exist) and then we apply these definitions and determinations to the scenario of abortion to see if any rights have in fact been violated.  With regard to this topic, we must also examine the consistency and efficacy of a person’s position on the issue in terms of how well it achieves the aforementioned goal or purpose of having and protecting rights and freedoms in the first place.  It goes without saying that if a person’s position on the issue is such that it’s implementation through any proposed legislation would effectively increase suffering in the world and/or increase the magnitude of people being forced to do things that they don’t want to do, then that person’s position is self-refuting in that it directly contradicts their ultimate reason for wanting to protect individual rights – unless their goal for protecting individual rights substantially differs from the one I’ve stated above, in which case, we would have to evaluate how rational any other stated goal would be in comparison. 

We must also examine the consequences of taking someone’s position on the matter to its logical conclusion, seeing how it would be applied in definitively similar situations, whether or not there would be special exceptions to the rules proposed, and once again whether all of those conceptual elements are consistent with one another.  Ultimately, how we choose to define terms (and their specificity) within this topic of discussion is important for determining the tenability of anybody’s position on the matter.  Let’s take a look at some of the primary arguments that have developed over time while trying to clarify some terminology and definitions along the way.

The Argument for Bodily Autonomy

Perhaps the most primary and fundamental argument in favor of protecting a woman’s right to choose to terminate a pregnancy is the argument for bodily autonomy.  In it’s basic form, it simply asserts that an individual has the right to choose who or what uses their body, for what purpose, and for how long.  The most common (and uncontroversial) examples of applying this very basic principle would be preventing a person from being forced to donate blood, tissue, or organs to another person, even if in doing so, it would potentially save that other person’s life.  If anyone abides by this principle and doesn’t believe that a person should be forced to donate blood, tissue, or organs to another person (to use these common examples) then the same principle would also forbid forcing a woman to donate blood, tissue, or organs to an embryo or fetus, even if in doing so, it would potentially save that embryo or fetus’ life.  During pregnancy, starting from conception, the embryo and later fetus indeed use the woman’s uterus, her blood, her tissue (including for the placenta that eventually forms) and even the woman’s food and oxygen resources. This is arguably the most extreme example of one person using another person’s body. If in fact the embryo or fetus’ use of the woman’s body is against the woman’s consent, then a right to bodily autonomy protects that woman’s right to abort that pregnancy, regardless of whether or not that fetus has no chance of surviving as a result.

Some might object and say, what about the embryo or fetus’ rights? Shouldn’t they have the same rights as every other human being? Well, if we treat all human beings equally and give them all the same rights (which is hardly controversial), then this amounts to giving the embryo or fetus the same rights to bodily autonomy as is afforded to the woman. However, the embryo or fetus doesn’t have any other person who is trying to use their body against the consent of that fetus (nor does that fetus have any consent on the matter one way or the other, although this is irrelevant in any case). Thus, one would have to afford the fetus special rights (a right to use another person’s body against their will), and this is a right that isn’t even granted to children that are already born, since a child’s mother isn’t forced to donate an organ, blood, or tissue to that child, even if it can potentially save that child’s life. Thus, arguments against a woman’s right to choose to terminate a pregnancy are only tenable if one also denies the right of bodily autonomy. Furthermore, if this right was only denied to a woman with respect to a fetus inside her (and not denied to anyone else), and thus is not consistently applied in all other cases, then we have a special right for fetuses that is being argued for, thus arguing against equal rights for all human beings. The only way to reconcile this and make the individual rights equal for all human beings (while attempting to preserve the life of the fetus) would be to completely abandon the right to bodily autonomy which seems like a position that almost nobody would choose to adopt.

On top of this, if one were to grant these same special rights to a less developed human being residing in a pregnant woman, such as a fertilized egg (the first stage of pregnancy), then women would also lose the right to take certain birth control medications. For example, while common birth control medications such as “the pill”, Norplant, or any other chemical birth control medications primarily function by preventing ovulation and impeding sperm, this isn’t 100% effective and so if the chemicals fail to prevent ovulation or fertilization, then they end up preventing implantation of the fertilized egg in the uterine wall, thus aborting the pregnancy. So it must also be kept in mind that if these special rights were granted to any developing human life residing in a woman’s body (whether a fertilized egg, embryo, or fetus), in order to remain consistent with this reasoning, one would also be taking away a woman’s right to use the most common forms of birth control in existence (i.e. chemical/hormonal and IUD methods) since it is well known that they often lead to abortions when they are used.

Defining “Personhood”

Another prominent argument in favor of a woman’s right to choose whether or not to terminate a pregnancy, involves the definition of personhood. In the case of the aforementioned argument for bodily autonomy, it was mentioned that the fetus could indeed be granted the same rights as the woman carrying that fetus, and it still wouldn’t deny the woman the right to abort that pregnancy since it is the woman’s right to bodily autonomy that is being violated in that case. However, it is also worth asking on exactly what grounds are people arguing that the fertilized egg, embryo, or fetus should in fact be granted the same rights as the woman carrying it, or any rights at all for that matter? This comes down to defining what exactly we are granting individual rights to. For example, are we granting rights to a fetus because it is human or has human DNA? A skin cell is also human and has human DNA, but we don’t grant rights to skin cells or the like so there is something else more specific under consideration here. It seems that the primary factor here pertains to defining personhood, for it seems undeniable that it is people that should have these shared individual rights. So what exactly is a person or individual and how do we define that concept?

One might argue that a person is simply a human body, but this can’t be correct, because we don’t grant rights to deceased human bodies. We could further clarify the definition of a person to be a human body that isn’t dead, but what about a brain-dead human body? If my mother became brain-dead but remained on life support (with a beating heart and functional organs), and I was given the option to “pull the plug”, if I chose to do so, would I be killing my mother? One way to determine the answer to this question would be to ask another, namely, who or what is my mother exactly? Would my mother be the brain-dead (though otherwise living) human body that lies before me? It may look like my mother, but I would argue that this body isn’t my mother at all, for my mother is a personality, an identity, a collection of memories, or at the very least a conscious and self-aware being that experiences perceptions and emotions.

Who my mother is exactly is ultimately contingent on the configuration and state of her brain, for it is our brain that manifests our personal identities and any particular self. To prove this, one need only consider the fact that if your brain were swapped with that of another person, you would cease to be you even if the rest of your body was kept original and intact. “You” would now have the personality, memories, thoughts, values, interests, likes and dislikes of that other person. On the other hand, you could swap your arms or legs or various other body parts with another person (or simply get them amputated), and you would still be you (so long as your brain was kept intact).

So to return to my hypothetical scenario involving pulling the plug on a brain-dead mother, because my mother is no longer alive in that case, but rather it is only her body that is alive, my pulling the plug would not in fact be an act of killing my mother. In fact, it wouldn’t even be an act of killing “a person”, because as was just illustrated, a person is contingent on a living brain, and more specifically a living brain with a particular configuration and minimal set of features (such that it has conscious experiences at least some of the time). This just goes to show what we value in a person and why we want people to have protected individual rights in the first place. It isn’t because they are living human bodies, but because we know that “people” are conscious, thinking beings and we value this fact and empathize with them and their experiences. We don’t want people to suffer because we know what it feels like to suffer (to varying degrees), and to consider the contra-positive, we also want to maximize the satisfaction and well being of people. So if a particular human being is not able to experience anything at all (that is, there are no perceptions, and thus no consciousness), then what we value in how we define a person is missing in this case, and thus the ultimate purpose for giving that human being rights is no longer applicable, for that human being is unable to suffer, let alone experience anything at all.

Now if we return to the concept of a fertilized egg, embryo, or fetus, we can apply the same reasoning and ask the same questions. When exactly does the fetus have the requisite brain structures developed such that it can be conscious and experience anything at all (much like my hypothetical mother was before she was brain-dead)? Well, a fetus doesn’t actually become neurologically active until approximately the fifth month of gestation (an event that the medical community refers to as “quickening”). It is at this point that some of the physical hardware (a complex form of the cerebral cortex) is in place for some future capability of consciousness, however the thalamo-cortical complex is integral for consciousness as well and doesn’t begin to materialize until sometime between the 24th and 28th week of gestation. It isn’t until about two months after that (32nd to 36th week), when a synchronous electroencephalographic (EEG) rhythm starts to signal that there is in fact a global neuronal integration taking place – a process that is a fundamental element of consciousness, working memory, etc.

Thus, before the fifth month of pregnancy (the 20th week), the fetus’ brain hasn’t nearly developed enough of the requisite hardware to be conscious (let alone to be self-aware), and thus it is unable to form an individualized personality, and therefore it is not yet a person based on the definition and reasoning given earlier. It doesn’t yet have this personhood status, the very status that we value and thus the very fundamental status that motivates us to ascribe individual rights to a person in the first place. It should also be noted at this time that the majority of elective abortions on record occur before the fourth month of pregnancy, which is several weeks before the fetus is even capable of being conscious, let alone well before it is even capable of beginning to develop any kind of personality or identity, which are necessary attributes in order to be considered a person as defined above.

Are Pro-Life/Anti-Choice Arguments Tenable?

So there are indeed very strong arguments for protecting a woman’s right to choose to terminate a pregnancy including the argument for bodily autonomy and the argument for defining personhood, using reasonable metrics that are based on what we fundamentally value in “people”, and thus why we want people to have protected individual rights in the first place. Arguments against a woman’s right to choose to terminate a pregnancy are likely to be ideologically untenable in that they deny a right to bodily autonomy that I think most people aren’t willing to universally (and thus consistently) argue against. These arguments also tend to rely on defining personhood using criteria or attributes that are either arbitrary, not universally applicable or that are unreasonable because of a fundamental misunderstanding of what we actually value in a person. Furthermore, these arguments are also pragmatically untenable since they also deny women the right to use the most common forms of birth control in order to remain consistent with the basic principles that constitute a pro-life/anti-choice position. For these reasons and more, my position on the issue has changed markedly over time, and after careful consideration of the arguments both for and against a woman’s right to choose, I am happy to say that I finally adopted what I found to be the most reasonable, rational, consistent, and ultimately tenable position on the issue.  Indeed, I support a woman’s right to choose, and I believe that the facts demonstrate this to be the most moral position to have on the matter.

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The Placebo Effect & The Future of Medicine

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The placebo effect has been known for a long time, and doctors and medical practitioners have been exploiting its efficacy for a number of ailments.  Whether it is sugar pills, a fake surgery, or even prayer, the power of belief and the psychological effect on our physiology is real and undeniable.  While the placebo effect may have its roots (or been most thoroughly exploited) in various religions, through the power of belief, it has been used by non-religious medical practitioners for quite some time now, and it is starting to be investigated much more thoroughly in cognitive neuroscience, and psychology.  Scientists are beginning to design and implement new techniques that take advantage of this effect of the mind helping to heal the body.  It’s become a fascinating area of research with some potentially huge benefits that may prompt a significant paradigm shift in the future of medicine.

A major advantage of placebos (at least those in the form of a pill or injection) is that they don’t require the expensive R&D and drug-synthesis manufacturing processes that traditional treatments do, which means that there are likely billions of dollars that can be saved in the future, as well as the very important benefit of greater environmental sustainability, by consuming less energy and creating less hazardous waste in the pharmaceutical manufacturing process.  In the case of placebic-surgeries (which have been successfully performed), if surgeons simply have to make a far less complicated incision or two, along with some other protocol and ambiance considerations and requirements to produce the desired effect, then the costs of the far simpler operation are drastically reduced, as well as any chances of malpractice or other long-term complications resulting from the surgery.

One thing that will have to be considered as we start making greater use of these placebic treatments (specifically “drugs” and surgeries), is how the pricing and costs associated with placebo options will be decided for a patient.  Will placebos be as expensive as normal drugs (if they are comparably effective), or will the decreased cost of placebo manufacturing offset/reduce the cost of other drugs so that the average trip to the doctor will be cheaper for everyone?  As always, we will likely have to continue battling with pharmaceutical companies and or medical practitioners that take advantage of the cost savings just to increase their own profit margins while giving no trickle-down savings to the patient.  In the grander scheme of things, having healthier people at the same cost that we currently have is still better, but nevertheless, we can only hope that these discoveries will continue to reduce the costs for the patient as well.

As for other types of placebos, such as meditation, prayer, various rituals, etc., since these placebos do not require any physical mediums or materials per se (or at least not in many cases), they are relatively inexpensive, if not entirely free in some cases.  Modern medicine, however, is also making more use of similar placebo methods, that is, placebos that don’t require the intake of a chemical nor require any surgery.  In fact, one can certainly argue that modern medicine has been utilizing these “non-material” placebos for quite some time already.  For example, various psychological treatments have been used to help heal people with all kinds of ailments, many of which are psycho-somatically induced, and all of which can be exacerbated by hypochondria, pessimism, and other causes of stress — and the placebo effect is certainly a likely contributing factor in many of these successful treatments.  These kinds of treatments could very well be applied in many (if not all) other cases that aren’t currently considered “psychological” ailments.  Putting this all together, I think we are going to start seeing a shift in medicine where psychology, cognitive and neuroscience are going to combine with modern “material” medicine to form a more obvious hybrid.  This integration will be significant, as currently many medical practitioners or schools of thought within medicine have a large divide between what are believed to be either psychological or physical ailments.  In reality though, it appears that every ailment is actually a combination of the two that can be more effectively treated, when both aspects are treated rather than merely one or the other.  After all, the brain and the rest of the body operate as a single unit, and so they should be treated as such.

Another positive discovery relating to the placebo effect is the fact that even if people know that they are being given a placebo, it is still effective, as long as they believe that the placebo is effective.  A more common concern regarding the placebo effect is that it will lose all efficacy if patients are informed that they are receiving some kind of placebo, however it turns out that this isn’t the case at all.  To give an example, in a recent study at the Harvard Medical School, people with irritable bowel syndrome were given a placebo and they were informed that the pills were “made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.”  Then the researchers found that despite being aware that they were taking placebos, the participants rated their symptoms as “moderately improved” on average.  This seems to imply that it is the belief in efficacy of a particular treatment that houses the placebic potential for healing, regardless of the substrate used to implement it, and this solves a lot of ethical complications regarding the desired disclosure that a patient is receiving a placebo.

If the belief in the efficacy of a placebo is the primary factor for the placebo’s effectiveness, this would imply that stronger belief will produce a stronger placebo effect.  So it appears that one of the most major challenges in producing ever-more effective treatments within this domain, is going to be finding ways to increase the belief in a treatment’s effectiveness (as well as other psychologically beneficial factors including being generally optimistic, reducing stress, and other factors that haven’t yet been discovered).  It may even be possible one day for this “belief” maximization (or the neurological effect that it causes) to be accomplished by physically altering the brain through various types of electrical stimulation or other neurologically-based treatments, so a person wouldn’t need to be convinced of anything at all.  On a related note, I’d like to mention that we also need to consider that the opposite effect, that is, the “nocebo” effect, also exists and presumably for the same psychological reasons.  That is, by a person believing that something will harm them or that they are getting sick, even if there is no actual pathogen or physical medium to produce the illness, they can actually get sick and make things much worse.  For a powerful example, there were chemo-therapy participants in a certain study, some of which only got a placebo, and they still developed nausea and had their hair fall out (alopecia) because of their expectations of the treatment.  So the placebo effect works both ways, and this means that medical treatment will also likely change with regard to finding new ways of countering the “bad news” of a diagnosis, etc., possibly through the same kinds of psychological and neurological techniques.

Nobody is sure exactly when the placebo effect was first discovered, but it was likely unknowingly discovered many thousands of years ago in various cultures with particular religious beliefs, including those that involved prayer and faith healing, shamans and other medicine men, etc.  Without seeing any material cause or knowing what was causing its efficacy (i.e. dynamics in the brain), people no doubt chalked up many positive effects to the supernatural, whether by the interventions of some god or a number of gods, magic, etc.  So this appears to be one of many examples of how natural selection favors not only certain genes, but also certain memes.  If people began to spread certain religious memes (ideas) that promoted self-healing by utilizing the power of belief, they would be more likely to survive, and this would be yet another factor in explaining why religions formed, why they’ve been as ubiquitous as they have, and why they’ve propagated for so long throughout human history.  To be sure, it could have been the case that humans long ago experienced the placebo effect (without knowing it) and this led to the development of certain religious rituals or beliefs (because the cause was mis-attributed or unknown), or it could be that certain religious beliefs that were formed for other reasons happened to produce a placebo effect (and/or to strengthen it by other psychological factors).  Either way, it was a very valuable discovery indeed.  Now that we are starting to better understand the real physiological/neurological/psychological factors that produce the placebo (and nocebo) effect, we can continue advancing a scientific world-view and continue to increase our well being in the process.