Why end-of-life care is not ethically the same as abortion

Georgia Gov. Brian Kemp signed a so-called heartbeat bill into law today which makes abortion illegal after it becomes possible to detect a fetal heartbeat. CNN gave the story the prime spot on its home page and quoted some of what Kemp said when signing the bill:

“(The bill) is very simple but also very powerful: a declaration that all life has value, that all life matters, and that all life is worthy of protection,” Kemp, flanked by supporters of the bill, said Tuesday morning before signing the legislation at the state Capitol.

“I realize that some may challenge it in a court of law. But our job is to do what is right, not what is easy. We are called to be strong and courageous, and we will not back down. We will always continue to fight for life.”

But CNN made the story part of a larger block which looked like this:

You may notice that nearly all of this block presents a clear perspective on the bill and on abortion in general. The first story after the main one is “Opinion: Georgia GOP’s abortion bill will hurt women” was written by the president of NARAL. There’s no opinion piece from anyone at a pro-life group supporting the bill. Maybe CNN couldn’t find any?

There’s also a video with a story from a dissenter to the bill and a piece pointing out that a similar law in Iowa was struck down and won’t be appealed (Message: This Georgia law won’t be around long). Finally, there’s a piece titled “Nurse: An abortion is not an execution, Mr. President.” The nurse in question has written a book about hospice care and argues the lessons learned from dealing with dying patients are applicable to abortion. This is an argument I’ve seen before and it always strikes me as the sort of intentionally dishonest argument that only appeals to the already convinced. Here’s a bit of the piece:

Talking about abortion in terms of ethical decision making may be troubling to abortion foes, but besides being a mother, I’m also a nurse who cares for patients at the end of their lives. For me, looking at arguments about abortion in the context of how best to care for dying patients can clarify the complexity of the ethical issues in abortion.

In my book “Critical Care,” I wrote about an elderly female patient who was non-responsive and on a high-volume breathing mask because her lungs were filled with cancerous lesions. Her family had made the difficult decision to take the breathing mask off, letting the patient die. Without the mask she would gasp for breath, suffering greatly, and frequent doses of morphine would be needed to relieve this air hunger. I took the mask off the patient and then gave her a dose of morphine every few minutes until she died. Afterward, another nurse commented, somewhat bitterly, that we shouldn’t tell the family we had “killed their mother.”

I felt the truth of that nurse’s statement and its unfairness. I made sure the patient died comfortably, and in doing so helped her die, but I had not actively sought her death. Ethicists would explain what happened as the doctrine of the double-effect: It is permissible to cause harm as a side effect (or “double effect”) of achieving a good result as long as the harm wasn’t intended.

I would agree that what the nurse did, in this case, might be seen as a bad thing in general terms (helping someone die) but in this case, it was for a good reason (the patient was non-responsive and would never recover). The goal of the family was to avoid the immediate suffering of a beloved family member who had nothing else in their future.

Not everyone has gone through a traumatic situation like this with a family member but many people have made decisions like this regarding an aging pet. I’m not suggesting the gravity of the situation is comparable. It’s not. But the decision-making has a similar ethical basis. At some point, the important thing is that the animal not suffer any more than is necessary. If a dog or a cat is brought to the vet to be put down it’s usually because they are old, fragile, and in increasing pain. There’s no real hope of recovery or a return to a better life, just the prospect of the situation and the suffering getting worse. So a decision is made to avoid that suffering. It’s a painful decision for most people, even knowing the end was coming with or without intervention.

Abortion is nothing like that situation in most cases. Most unborn children are not destined for a future of immediate suffering leading to death. Most would be born and lead entire lives lasting decades. What the abortion is ending isn’t just more misery followed by death but a full life. That’s not at all the same thing as dealing with people in hospice care. In one case the ethical goal is to avoid needless suffering as life is waning away. In the other case, the goal is to end new life as it is waxing into being.

These don’t seem like similar situations to me at all. They seem like opposites.