By Virginia Heffernan
Happy birthday, abortion! You’ve bedeviled philosophers, politicians and doctors for 25 centuries! That’s right: Since around the fifth century B.C., when the Hippocratic oath for physicians first contained a clause about abortion, we’ve driven ourselves insane over the implications of a simple, common, ancient medical procedure.
As the explosion of abortion punditry in Campaign 2012 made clear, the issue exerts a radioactive fascination. Millions of temples and keyboards began pounding in August after Todd Akin, the Republican candidate for Senate in Missouri, engaged in some pseudoscientific theorizing on the impossibility of pregnancy after a “legitimate rape.” And the number must have reached Carl Sagan proportions after Richard Mourdock, the Republican candidate for Senate in Indiana, uttered this line: “Even when life begins in that horrible situation of rape, that it is something that God intended to happen.”
Yikes. Did Mourdock say rape is divinely inspired? Not exactly. Journalists sensitive to religious cosmologies like Amy Sullivan of The New Republic explained that Mourdock had seen God’s intention only in the life conceived during rape, not the rape itself.
That clarification was useful. It spared Mourdock from the gruesome charge that his God advocates rape—or is Himself the rapist’s accomplice. The Sullivan exegesis put these distracting and chilling questions to rest, more or less.
But Mourdock’s comment still managed to throw into relief an intense disagreement between atheists and religious people. And by “religious people,” I mean everyone from Buddhists to evangelicals to plain old “everything happens for a reason” American optimists.
This disagreement concerns the mind-consuming question of whether the full catastrophe of existence—including the fact of violent crime, or Hurricane Sandy, or the next president of the United States—might be said to reflect something like “God’s will” or “the order of things” or even “the spiritual perfection of the moment.”
You think abortion makes people squeamish? Try the idea, common to many contemplative traditions, that everything in reality, however painful, is exactly the way it’s supposed to be. Some people feel liberated beyond all understanding by this notion. Others feel sickened, crippled, outraged, disempowered.
But if that’s Mourdock’s logic, we might hold him to it—for consistency’s sake, if nothing else. If conception during forced copulation reflects God’s will, in other words, and if rape itself might even reflect that inscrutable will (since it too is part of reality), then abortion—common and legal as it is in the United States—also reflects God’s will.
And this is where the tension surrounding abortion has always resided. Is the art of medicine—the protection and promotion of life and health—best practiced by allowing or prohibiting abortion?
I’ve found that this tension is thoroughly resolved in the Hippocratic oath, of all places. Back at the start. We need not visit Roe v. Wade or the teachings of Operation Rescue. In the ancient oath, the Apollo-worshipping internist vows above all to protect “health and life.” He then specifically says that, toward this end, he won’t perform euthanasia; he won’t perform abortion; and he won’t remove kidney stones and gallstones.
Does that mean these procedures are in themselves immoral? Far from it—as anyone who has had gallstones removed might agree. Rather, these three procedures, we are made to understand, require both philosophical and manual work for which early physicians, trained in medicine but not abdominal surgery, were not qualified. The gallstone sufferer needs a surgeon trained specifically in the art of cutting for stones, says the oath. For a generic medicine man to undertake it would be to risk doing harm—the signal crime against the art of medicine.
The would-be suicide, on the same logic, should administer poison to himself, or have a trusted and willing friend aid him. A physician is not qualified to determine the wishes of a euthanasia candidate, and thus might again betray his oath by doing harm.
Finally, those early nonsurgical doctors are not qualified to perform abortions because they don’t have the manual skills or the philosophical ones. Internists are not qualified to determine when this surgery, which is prima facie harmful, favors the life of the patient, as stone removal does.
Every pregnancy, in every woman, under every circumstance affects her “health and life.” And “health and life” are the very ideals that physicians all first pledge to protect. If a woman doesn’t want to be pregnant or bear a child, she has a complaint that’s deeply psychological and deeply physical—at least as physical as gallstones. If medical men and women don’t feel qualified to gauge the distress and seriousness of a woman presenting with pregnancy and asking for an abortion, they should refer her to someone—a gynecological practice, Planned Parenthood—that is qualified to assess the patient and treat her.
There should be a comparable oath for all politicians. (Would that we had drawn it up four years ago. There’s still time for Campaign 2016!) Some topics should be left to experts and avoided by male politicians with neither philosophical nor medical training, nor firsthand appreciation of the effects of pregnancy and childbirth on health and life.
Richard Mourdock may have just been voicing an armchair view of an age-old medico-philosophical issue that’s consistent with his religious beliefs. But to present outlandish views on the subject of abortion, without the qualifications to do so—as too many politicians and pundits have done over the past three months—is to do harm.