A Case for Voluntary Abortion Reduction

Ariel Simnegar 🔸20 Dec 2022 13:23 UTC
39 points
150 comments13 min readEA link

EDIT 2022-12-22: Feedback in the comments has updated me on how structural decisions I made in this post clouded its argument and the ensuing dialogue.

  • “Cause Prioritization may Underrate The Effect of Near-Term Interventions on Population Size” would have been a better choice of title and framing for discussion. See here for a summary of how this post’s argument should have been outlined, and some explanation of why I originally made the choice to headline abortion.

  • One of this post’s proposed interventions—the suspension of EA funding for charities which reduce the amount of future people—wouldn’t satisfy some reasonable definitions of “voluntary.” The definition of “voluntary” used in this post is “not compelling the removal of choice.” I wrongly engaged in some motivated reasoning in the semantic debate of that definition, and I’d like to shout-out bruce for helping me realize that. See here for a transparent description of my thought process behind the post’s framing of “voluntary abortion reduction.”

  • The “Exercising Personal Autonomy to Help Others” section was previously titled “Personal Autonomy Shouldn’t Preclude Intervention,” but a commenter convinced me that the previous title claimed more than the argument showed.

  • Thanks so much to the commenters for their engagement!

Trigger warning: Abortion is a delicate topic, especially for those of us who’ve had abortions or otherwise feel strongly on this issue. I’ve tried to make the following case with care and sensitivity, and if it makes anyone feel uncomfortable, I wholeheartedly apologize.

Disclaimer: This essay specifically concerns voluntary abortion reduction. Any discussion of involuntary intervention is outside of this post’s scope.

Thanks to Ives Parrhesia, Marcus Abramovitch, Ruth Grace Wong, and several anonymous helpers. Their help does not constitute an endorsement of this essay’s conclusions.

Summary

  • Many EA principles point us towards supporting voluntary abortion reduction:

    1. Moral circle expansion.

      • We’re receptive to arguments that we should expand our moral circle to include animals and future people.

      • We should be open to the possibility that fetuses—the future people closest to us—could be included in our moral circle too.

    2. Our concern for neglected and disenfranchised moral groups.

    3. The metric of (adjusted) life years.

      • We commonly use (adjusted) life years as a measure of the disvalue of problems and the value of interventions.

      • This metric arguably doesn’t distinguish between fetal deaths and infant deaths.

    4. Singerian duties to give to help those in need.

      • We’re typically sympathetic to arguments that we should proactively help those in need, even if it reduces our personal autonomy.

      • We should consider whether we should help our children the same way.

    5. Longtermist philosophical views.

    6. Moral uncertainty’s implications for a potential problem of massive scale.

      • Given abortion’s massive scale, even a small chance that fetuses are moral patients could imply that we should do something about it.

  • In that regard, we should carry out the following interventions:

    1. Shift our family-focused interventions to spotlight mothers’ physical and mental health, and support adoption as an option.

    2. Suspend our support for charities which reduce the amount of near-term future people until we can systematically review the effect of the above moral considerations on the morality of the charities’ interventions.

  • In our personal lives, we should:

    1. Understand the situations of people we know who are considering abortion and do whatever we can to support them in having their babies the way they would like.

    2. Help each other to be loving parents and raise thriving children, whether or not some of us have abortions or choose to not have children.

Introduction: Moral Circle Expansion

Future people count, but we rarely count on them. They cannot vote or lobby or run for public office, so politicians have scant incentive to think about them. They can’t bargain or trade with us, so they have little representation in the market. And they can’t make their views heard directly: they can’t tweet, or write articles in newspapers, or march in the streets. They are utterly disenfranchised.

...

The idea that future people count is common sense. Future people, after all, are people. They will exist. They will have hopes and joys and pains and regrets, just like the rest of us. They just don’t exist yet.

Will MacAskill, What We Owe The Future (2022), pp. 9-10.

As EAs, we’re no strangers to expanding our moral circle. We’re rooted in the idea that distance shouldn’t prevent us from caring about our fellow people. We allocate tens of millions of dollars to reducing the suffering of animals. 46% of us voluntarily undertake the significant personal inconvenience of vegetarianism/​veganism to align our actions with our concern for nonhuman animals. Some of us even consider the interests of insects, each of which might experience a mere flicker of the hopes, joys, pains, and regrets a person will experience over their lifetime.

Our future children, however, will experience all of the same hopes, joys, pains, and regrets that we do over our lifetimes. As EAs, we spend tens of millions of dollars on protecting them from catastrophic risks and ensuring we can pass on the torch of safeguarding the long-term future to them. How can we not? Our future children are the future people closest to us.

About 73 million abortions occur each year.[1] This is a greater number than the annual amount of people killed by malaria, cancer, or heart disease. This annual number is more than the sum total of people killed in all genocides in history. In fact, each year, more abortions occur than the number of deaths by all causes combined.

Many EA principles point us towards the possibility that we should personally support voluntary abortion reduction. Towards that premise, we’ll explore the potential for voluntary abortion reduction to be an EA cause area and suggest some related interventions. Whether or not some of us have abortions, the case will be made that we should help each other to be loving parents and raise thriving children.

Fetuses Could be Moral Patients

Peter Singer contends that “arguments [of moral personhood] apply as much to the newborn baby as to the fetus.”[2] When EAs measure the disvalue of death by the amount of (adjusted) life years a person is deprived of, infant deaths are considered worse than adult deaths, and it’s arguable that this “deprivationist” approach doesn’t morally distinguish between a fetal death and an infant death.[3] In 2020, GiveWell accounted for this possibility by weighing the death of a fetus one month before birth to be about the same as a 65-year-old’s death. In consequentialism, it isn’t easy to draw a coherent line separating fetuses who lack moral patienthood from infants who do. These observations (among others) prompt Bryan Caplan to remark that “the utilitarian case against abortion seems very strong.”[4] Overall, whether or not these arguments are decisive, it seems like we should be receptive to the possibility that fetuses and infants could have a similar place in our moral circle.

Exercising Personal Autonomy to Help Others

When discussing abortion, it is crucial for us to emphasize the importance of personal autonomy. Advocating for voluntary abortion reduction asks women to undertake substantial bodily, economic, and social costs. Choosing to have a baby means choosing to undertake pregnancy’s toll on a woman’s body, the physical pain and economic cost of childbirth, and potential social stigma. After a woman has had her baby, she has to make a further choice between the economic cost of raising her child and the social stigma of putting her child up for adoption. If she decides to raise her child, she will likely shoulder a disproportionate part of the cost of raising a child. These are all deeply personal decisions which profoundly affect women’s physical and mental health.

As EAs, many of us believe not only that it is virtuous to help our fellow people in poverty, but that there are compelling ethical reasons for us to proactively do so. The consequentialists among us would say that it would be morally wrong for us to not help our fellow people in poverty, even if helping them reduces our personal autonomy by preventing us from enjoying some of the amenities of the wealthy countries we typically reside in. Similarly, most of us would agree that prospective mothers shouldn’t drink or smoke heavily while pregnant, even though those mandates curtail their bodily autonomy, because the enjoyment of those actions isn’t commensurate with the potential future suffering those actions could cause to the mother’s child.

Our future children are the future people closest to us. Each of them will enjoy the summer days of youth, feel the blissful ache of teenage love, laugh with their friends in middle age, and enjoy watching their own grandchildren giggle as they play. When choosing whether or not to have an abortion, we’re choosing between granting our child their future or cutting it off right before it begins. Toby Ord writes that “Any plausible account of population ethics will involve…making sacrifices on behalf of merely possible people.”[5] Choosing to have a baby involves incredible personal sacrifice, but it seems that if anyone should be sympathetic to the idea that we have an ethical duty to carry our children to term, it should be EAs.

Moral Uncertainty Leans Towards Intervention

Consider the case of voluntarily deciding whether or not to have an abortion under moral uncertainty:[6]

Voluntary choice:Fetuses are moral patientsFetuses are not moral patients
Have abortionVery gravely wrongPermissible
Give up for adoptionPermissibleSignificant personal cost


If there’s a significant chance that fetuses are moral patients, even though carrying her child to term and giving them up for adoption carries a considerable personal cost, it seems that the decider should still do that rather than have an abortion. Indeed, several philosophers endorse this face-value application of moral uncertainty to abortion.[7] However, this rudimentary approach fails to assign credences to many relevant moral views:

  1. Views where abortion is intrinsically good:

    1. High critical level[8] views (the adopted child’s expected wellbeing is below the critical level where the mother ought to have the child). Note that when solely considering a person’s wellbeing, any person whose average future wellbeing is expected to be below the critical level should be preferred by a consequentialist to die rather than continue living. It seems likely that adopted children have greater expected wellbeing than people in extreme poverty,[9] and that the economic value added by an adopted child is greater than that of a person in extreme poverty. Notwithstanding many other relevant considerations, it’s arguable that endorsing this view could mean opposing lifesaving interventions for people in extreme poverty, which would contradict Singerian EA precepts.

    2. Anti-natalism.[10]

  2. Views where abortion is neutral /​ justifiable:

    1. Deontological views where personal autonomy is held as such a paramount value that it outweighs the loss of future life.[11] Note that this view is of less concern in the voluntary case than in the involuntary one, as no compulsory limitation on personal autonomy is being discussed here.

    2. Person-affecting views (the choice whether or not to create a new person is morally neutral) where fetuses are not people. Note that fetuses may be able to suffer from as early as 12 weeks from conception,[12] so many person-affecting views would consider the fetus a person by then.

    3. Singerian duties of beneficence (even if abortion is intrinsically wrong, there may be situations where abortion is compulsory if having an abortion enables one to do enough good to outweigh the future life prevented by the abortion).

  3. Views where abortion is intrinsically bad:

    1. The total view (the adopted child has positive expected wellbeing, so the mother ought to have the child).

    2. Low critical level views (the adopted child’s expected wellbeing is above the critical level where the mother ought to have the child).

    3. Person-affecting views (the choice whether or not to create a new person is morally neutral) where fetuses are people (e.g. some deprivationist views).

    4. The consistent life ethic, which opposes abortion, capital punishment, (unjust) war, and euthanasia.

    5. Views in deontology/​virtue ethics where taking responsibility for the consequences of one’s actions is held as a virtue, and pregnancy/​childbirth is seen as an expected possible consequence of sex.[13]

    6. Views in deontology/​virtue ethics where one’s duty towards one’s family exists even when one’s family is still in the womb.

After enumerating some of the above perspectives, Will MacAskill, Krister Bykvist, and Toby Ord argue that drawing a conclusion on abortion from moral uncertainty alone would require “substantive and probably controversial assumptions about what credences one ought to have across a wide array of moral views.”[14]

As EAs, we do make substantive and controversial claims about the credences of these moral views. Will MacAskill approvingly cites Hilary Greaves and Toby Ord’s argument[15] that as a population’s size increases, moral uncertainty compels one’s ethical view to approach a “low but positive critical level.”[16] Will strongly disagrees with person-affecting views, declaring that “all proposed defences of the intuition of neutrality suffer from devastating objections,”[17] and considers the anti-natalist view that “the choice to have children [is] unethical” to be “a mistake.”[18] Will concludes that “if your children have lives that are sufficiently good, then your decision to have them is good for them.”[19]

Those of us who agree with Will are implicitly staking out strong claims about the credences of moral views concerning abortion. We’re assigning minute credence to views 1a, 1b, and 2b, all of which pulled in favor of abortion’s permissibility. We’re assigning substantial credence to views 3a and 3b, both of which pull against abortion’s permissibility. Let’s make the simplifying assumption that the non-consequentialist perspectives on both sides of the discussion cancel out and/​or are assigned low enough credences that they may be ignored. If we’re maximizing expected choice-worthiness with the assumption that choice-worthinesseses are scaled similarly across theories, then we’re left with credences which very likely make abortion morally wrong. The exception would be when Singerian duties of beneficence compel us to have an abortion when it enables us to do enough good to outweigh the future life prevented by the abortion. In practice, the Singerian exception should virtually never occur for non-EAs, and shouldn’t necessarily be common for EAs either. For those of us who agree with Will (and with apologies to those of us who don’t), it seems plausible that moral uncertainty lends us significant reasons to personally support voluntary abortion reduction.

Child Replaceability Shouldn’t Preclude Intervention

If a mother has always intended to raise a single child, then whether or not she has an abortion along the way, she’ll still eventually raise a single child. If the consequence will be the same regardless of whether or not the mother aborts her child, then how can a consequentialist object to abortion? The aborted child can always be replaced.

Firstly, we should note that child replaceability might justify infanticide. If the mother has an infant and would like to “replace” them with a future child, so long as she has always intended to raise a single child and no other considerations count enough against it,[20] infanticide would be justified. To be fair, Peter Singer has admitted that “the position I have taken on abortion also justifies infanticide,”[21] so this concession is not without precedent.

If we agree that an adopted child’s expected wellbeing is above the critical level (which most of us should, as argued by the note on 1a in the previous section), then it seems that even if we accept replaceability, giving up the child for adoption is better than abortion. If the child is adopted, then two children can live above the critical level, but if the child is aborted, then only one child can live above the critical level.

Increasing the Amount of Near-Term Future People

Many of the above moral arguments for voluntary abortion reduction rest upon high credences in low critical level, relatively non-person-affecting, and pro-natalist views. These views are the same ones used by many longtermists to justify interventions to increase the amount of future people. It is debated whether increasing the amount of future people in the near term should be an EA cause area, how different it is from saving lives, and whether it is good at all. However, it seems that though the importance of increasing the amount of future people in the near term is debated, many EAs do agree that it is a good thing.

Many of this essay’s moral arguments for voluntary abortion reduction can be generalized to arguments for voluntarily increasing the amount future people in the near term. This generalization prompts some of the following interventions.

Interventions

Community Actions

As far as I know, no EA organization has undertaken a systematic review of how moral considerations could affect the morality of current interventions which affect the amount of near-term future people. On the contrary, several prominent EA organizations have endorsed charities which decrease the amount of near-term future people, with little to no published deliberation on relevant moral considerations:

  • The Life You Can Save (TLYCS) includes Population Services International, which encourages abortion, among their best charities. TLYCS’s endorsement includes zero discussion of potential moral caveats.

  • GiveWell designated Development Media International (DMI), which decreases family sizes, as a standout charity, while stating that they “have not deeply investigated DMI’s programming related to family planning.”

  • Charity Entrepreneurship (CE) gave seed grants to Family Empowerment Media and the Maternal Health Initiative,[22] both of which have the express purpose of preventing unintended births. CE’s explainer briefly raises the question of how much concern should be placed upon “the preferences of a child whose birth was averted,” but does not include any deliberation towards a definitive answer.

Though these charities have noble intentions, if any of the discussed moral considerations turn out to be relevant, then it’s plausible that they’re contributing to serious harm. Given this potentially massive negative externality, we should suspend our support for charities which decrease the amount of near-term future people, until we can systematically review the effect of the above moral considerations on the morality of the charities’ interventions. Instead of spotlighting family planning, we should shift our family-focused interventions to spotlight mothers’ physical and mental health, and support adoption as an option:

  • The Fistula Foundation advances mothers’ wellbeing through life-restoring surgeries and is endorsed by TLYCS as one of their best charities.

  • The Global Alliance for Improved Nutrition (GAIN) advances the wellbeing of women, girls, and children by increasing their access to critical nutrition. GAIN’s Salt Iodization Program is endorsed by TLYCS as one of their best charities.

  • Relaxation training and psychological services for pregnant women have been investigated as potential EA interventions because they reduce mothers’ stress during pregnancy, enhancing both mothers’ and children’s mental health.

  • Each year in the US, about 2% as many children are given up for adoption as are aborted. Both pro-abortion and anti-abortion pregnancy centers refer pregnant women to adoption agencies at only a 1% rate. It seems that social stigma, attachment to one’s baby, and incomplete counseling are all contributors to the unpopularity of giving up for adoption as an option.[23] Further research into improving the availability of this choice for pregnant women would be desired.

In Our Personal Lives

In our personal lives, we should:

  • Understand the situations of people we know who are considering abortion and do whatever we can to support them in having their babies the way they would like.

  • Help each other to be loving parents and raise thriving children, whether or not some of us have abortions or choose to not have children.

  • Support policies which support parents, including child tax credits and evidence-based daycare.

  • Advocate for societal infrastructure to reduce the disproportionate cost of childcare shouldered by mothers.

  • Support policies which improve the lives of children in foster care and make adoption easier.

  • Voluntarily choose to not have abortions. For me personally, committing to never choose abortion has aligned me with every other moral lesson I’ve learned from EA, including increasing my empathy, becoming vegan, and avoiding harming any living creature.

Just as you can live a good life by being helpful to those around you, donating to charity, or working in a socially valuable career, I think you can live a good life by raising a family and being a loving parent.

Will MacAskill, What We Owe The Future (2022), p. 251

Appendix

The Scourge of Spontaneous Abortion

Most pregnancies end within a few weeks of conception, when the embryo is unable to implant in the womb due to genetic issues, nutrient/​hormone deficiencies, or other problems. For consequentialists, this could be as much a loss as an induced (intentional) abortion, as it prevents a future person from having lived. The number of annual spontaneous abortions alone is a staggering 200 million. In “The Scourge,” Toby Ord argues that this means people who oppose abortion should “see it as one of the world’s greatest problems, if not the greatest problem.”[24]

Let’s suppose that an intervention were created which cures all embryos of their issues and ensures they will implant, and that the world’s families were to still have the additional children they counterfactually would have had (to sidestep child replacement concerns). The world population would begin increasing by 200 million per year on top of its existing growth rate. Assuming a low critical level and relatively non-person-affecting view, this would be close to as good as saving 200 million lives per year. Almost all of us (apart from our anti-natalist friends) would be thrilled by this, since it would blow everything we’ve ever done for human beings alive today out of the water. Toby Ord, who wrote an entire book about the importance of ensuring future generations come into being, should be ecstatic. However, the above scenario is quite idealistic, and there are more tractable interventions (which still accomplish steps in this direction) to reduce abortion in the near term.

Toby argues that since abortion opposers aren’t actively advocating for the above international effort, “few people really believe that full moral status begins at conception.”[25] This is just like how few people really care about global poverty (since they’re not donating all their money to AMF), the future of humanity (since they’re not donating all their money to MIRI), or animal welfare (since they’re not avoiding silk, shellac, driving, and walking on grass). EA’s thesis is that we should use reason to seek out the world’s most effective interventions, even if they end up seeming unintuitive or including in our moral circle beings which we previously ignored. There seem to be several EA-aligned reasons for why abortion could plausibly be bad. If there are 73 million abortions per year, then abortion could plausibly be very bad. If there are 273 million abortions per year (including spontaneous abortions), then abortion could plausibly be one of the greatest problems affecting human beings in the near term.

  1. ^

    Unintended Pregnancy and Abortion Worldwide. (2022, August 24). Guttmacher Institute. https://​​www.guttmacher.org/​​fact-sheet/​​induced-abortion-worldwide

  2. ^

    Singer, P. (2011). Practical Ethics (3rd ed., p. 169). Cambridge University Press.

  3. ^

    Other approaches to measuring the disvalue of death include the time-relative interest account and Epicureanism and are discussed by the Happier Lives Institute here.

  4. ^

    Caplan, B. (2018, April 5). Where Are the Pro-Life Utilitarians? Econlib. https://​​www.econlib.org/​​archives/​​2015/​​04/​​where_are_the_p.html

  5. ^

    Ord, T. (2021). The Precipice (p. 263). Hachette Books.

  6. ^

    Adapted to emphasize the decider’s voluntary decisionmaking from: MacAskill, William; Bykvist, Krister; Ord, Toby, ‘Practical Ethics Given Moral Uncertainty’, Moral Uncertainty (Oxford, 2020; online edn, Oxford Academic, 22 Oct. 2020), https://​​doi.org/​​10.1093/​​oso/​​9780198722274.003.0009, accessed 25 Nov. 2022.

  7. ^

    Moller: “[the moral uncertainty argument] does seem to suggest, however, that there is a moral reason—probably not a weak one—for most agents to avoid abortion” (‘Abortion and Moral Risk’, p. 443). Lockhart: “In the vast majority of situations in which decision-makers decide whether to have abortions, not having an abortion is the reasonable choice of action” (Moral Uncertainty and Its Consequences, p. 52).

  8. ^

    Within critical level views, there are momentary views, where one’s critical level at a given moment is dependent upon that moment, and whole life views, where the critical level remains the same over one’s lifetime. We’ll specifically consider whole life views here, where momentary views can be translated to whole life views by using the average critical level over one’s lifetime as the lifetime critical level.

  9. ^

    Bramlett et al: Adopted children in developed countries are 7.3% more likely to have “Parents concerned with learning/​development/​behavior” before age 5 (43.6% vs 36.3%) and 13.6% more likely to have “current health problems that are moderate/​severe” (21.2% vs 7.6%) (‘The health and well-being of adopted children’, p. S57). Devine et al: For people in extreme poverty, 84.8% had “stunted, wasted, underweight, or anaemic” development before age 5, 35.1% suffer from chronic illness in adulthood, and virtually all suffer from severe malnutrition for their entire lives (‘Health and Wellbeing in the Lives of the Extreme Poor’).

  10. ^

    Although it would be unusual, an anti-natalist view could still find abortion intrinsically bad. For example, an anti-natalist could find a person’s death bad, and consider fetuses persons.

  11. ^

    Galef, Julia. (2021, September 6). Twitter. https://​​twitter.com/​​juliagalef/​​status/​​1434985998312742929

  12. ^

    “Overall, the evidence, and a balanced reading of that evidence, points towards an immediate and unreflective pain experience mediated by the developing function of the nervous system from as early as 12 weeks.” Derbyshire, S. W., & Bockmann, J. C. (2020). Reconsidering fetal pain. Journal of Medical Ethics, 46(1), 3–6. https://​​doi.org/​​10.1136/​​medethics-2019-105701

  13. ^

    “Sometimes sex has unwanted consequences. There’s a convenient way to avoid those consequences – abortion – which would be very helpful. But if that convenient way to avoid the consequences hurts another person – the fetus – then we’re back into ‘take the consequences of your own action’ mode.” Alexander, S. (2020, July 22). Fetal Attraction: Abortion and the Principle of Charity. Slate Star Codex. https://​​slatestarcodex.com/​​2013/​​05/​​30/​​fetal-attraction-abortion-and-the-principle-of-charity/​​

  14. ^

    MacAskill, William; Bykvist, Krister; Ord, Toby, ‘Practical Ethics Given Moral Uncertainty’, Moral Uncertainty (Oxford, 2020; online edn, Oxford Academic, 22 Oct. 2020), https://​​doi.org/​​10.1093/​​oso/​​9780198722274.003.0009, accessed 25 Nov. 2022.

  15. ^

    Greaves, Hilary; Ord, Toby, ‘Moral uncertainty about population ethics’, Journal of Ethics and Social Philosophy, https://​​philpapers.org/​​rec/​​GREMUA-2

  16. ^

    MacAskill, W. (2022). What We Owe the Future (p. 250). Basic Books.

  17. ^

    Ibid. p. 234

  18. ^

    Ibid. p. 250

  19. ^

    Ibid. p. 251

  20. ^

    These considerations may include the infant’s reduced impact on the mother’s autonomy, time-relative interests, and the perspective that birth is the best Schelling point for abortion’s permissibility. On the final consideration, it’s worth noting that there isn’t much biological distinction between a late-term fetus and an infant, and it’s arguable that our greater disgust for infanticide than late-term abortion is due to societal influences rather than an actual moral difference. Peter Singer makes this argument (Practical Ethics pp. 169-174), albeit in support of the opposite conclusion.

  21. ^

    Singer, P. (2011). Practical Ethics (3rd ed., p. 173). Cambridge University Press.

  22. ^

    The Maternal Health Initiative’s founders raise the concern that “Certain views of population ethics may consider family planning as significantly less promising given the loss of potential population growth and additional total happiness,” and invoke child replaceability as a counterpoint. However, the possibility that these well-meaning interventions could cause active harm (as opposed to merely being less promising) is not discussed.

  23. ^

    Khazan, O. (2019, May 21). Why Women Choose Abortion Over Adoption. The Atlantic. https://​​www.theatlantic.com/​​health/​​archive/​​2019/​​05/​​why-more-women-dont-choose-adoption/​​589759/​​

  24. ^

    Ord, T. (2008). The Scourge: Moral Implications of Natural Embryo Loss (p. 15). The American Journal of Bioethics, 8(7), 12–19. https://​​doi.org/​​10.1080/​​15265160802248146

  25. ^

    Ibid. p. 19

Ariel Simnegar 🔸20 Dec 2022 13:23 UTC
39 points
150 comments13 min readEA link