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.
Here, I’m going to make a counterargument from a purely practical consequentialist perspective, without addressing your moral argument about the potential moral patienthood of the fetus or the moral urgency of increasing population growth.
I doubt that voluntary abortion reduction is a particularly tractable and neglected way to increase short-term population growth. Pew Research has a chart on the stances of major world religions on abortion, and most Christian churches, as well as Hinduism, are against. In other words, there’s already a lot of “abortion reduction” activity, using stronger measures than nice, voluntary persuasion.
The reasons most frequently cited were that having a child would interfere with a woman’s education, work or ability to care for dependents (74%); that she could not afford a baby now (73%); and that she did not want to be a single mother or was having relationship problems (48%).
In most countries, the most frequently cited reasons for having an abortion were socioeconomic concerns or limiting childbearing. With some exceptions, little variation existed in the reasons given by women’s sociodemographic characteristics.
So with abortion reduction, the pregnant women you’re targeting are:
Already facing the cost of carrying a pregnancy they don’t want to term
Don’t want the baby
Won’t realize any substantial benefit from having the baby
Are probably in a pretty fraught position in their lives in many cases
And you are trying to somehow convince them to carry that baby to term voluntarily so that someone else can enjoy the benefit. That sounds intractable. On top of that, we have to point out that this is an enormously politically charged issue. Those who are against abortion already have massive resources aimed at abortion reduction. Among pro-choice people, arguing for the moral urgency of reducing abortions is going to create a lot of political friction. I think that’s something we have to take into account from a sheer, practical tractability standpoint.
With 73 million abortions, only about 250,000 children are adopted annually worldwide, even though globally, 10 million children live in institutions, and 60 million on the streets. There are about 2 million people waiting to adopt in the USA. I’m not sure how many people want to adopt globally, but my guess is that overall, there’s only enough potential adoptive parents to provide homes for a small fraction of the children who’d be born if more parents chose adoption rather than abortion. What fraction of voluntary abortion reduction resulting in the child being raised in an institution or on the street would we consider an acceptable outcome?
I’d be tentatively more comfortable with measures taken to facilitate increasing the number of wanted pregnancies, including legalizing paid surrogacy services and subsidizing childcare and adoption of older children. Bans on paid surrogacy are connected to a broader, and in my opinion, deeply unethical and massively impactful ban on the voluntary sale, or in this case rental, of one’s own organs.
I’ve focused on this topic more in the context of kidney sales. There, the public is generally quite supportive of a government-paid option for kidney sales, and most healthcare providers support a trial of a compensation mechanism. You’d never know it from media coverage, though, because a small group of sophisticated political and religious operatives have managed to create a false impression of an ethical consensus against kidney sales. I would not be surprised if legalizing paid surrogacy has even higher levels of public support. That is what I’d lean into if this was my issue.
Great counterpoints! I don’t disagree with many of your conclusions, although I have a few nitpicks.
I think voluntary abortion reduction may be more neglected than you seem to imply, if we define neglected as “neglected by effective interventionists.” Since there remain more abortions per annum than deaths by all causes put together, it seems that “abortion reduction interventionists” aren’t doing a very good job. Similarly, there are many “global poverty interventionists” who don’t seem to be very effective, given that GiveWell has found interventions which are many times more effective than the mean, so we might call global poverty neglected the same way. So I think there’s an important sense in which voluntary abortion reduction is neglected—by effective interventionists.
On adoption, I agree with you that there’s only so many children the world’s adoption infrastructure can absorb, let alone deliver them to good parents who would lead them to thriving lives. However, it seems like improving this system’s efficiency (would-be adopters in the US probably shouldn’t have to wait as long or pay as much as they do to adopt) and improving the culture around adoption would be a good idea even if it would be unrealistic for the infrastructure to ultimately scale enough to efficiently handle every child in need.
I agree completely with your policy recommendations on surrogacy and organs.
Since there remain more abortions per annum than deaths by all causes put together, it seems that “abortion reduction interventionists” aren’t doing a very good job.
We can’t measure the success of an intervention by measuring the scale of the remaining problem. We need a reason to think that abortion activists are either ineffective or under-resourced, and given that the legality of abortion is trending downward both in the United States and globally despite rising trends in secularization, that just doesn’t seem plausible on its face. Furthermore, unlike many other charitable donors, anti-abortion activists really are primarily concerned with decreasing the number of abortions—and they’re willing to embrace all methods for doing so, including politics and even terrorism. “Voluntary abortion reduction,” honestly, sounds like one of the least effective means for achieving the aim of reducing abortions, although I could certainly be persuaded that I’m wrong on that point with data.
However, it seems like improving this system’s efficiency (would-be adopters in the US probably shouldn’t have to wait as long or pay as much as they do to adopt) and improving the culture around adoption would be a good idea even if it would be unrealistic for the infrastructure to ultimately scale enough to efficiently handle every child in need.
I want to point out that in the short run, we should actually have would-be adopters pay more and wait longer, because right now, the waiting list is enormous, and it never makes sense to address a shortage by subsidizing demand. It would probably be best if the money they pay went to the women who are having the children, even if by an indirect mechanism.
In the long run, if you did manage to eliminate the waiting list by increasing the production of children for adoption then yes, you would eventually run into the opposite need, to subsidize childrearing. But that cuts against your abortion-reduction cause.
Effectively, my model from a population-growth standpoint is this:
We have an acute child-supply shortage due mainly to paid surrogacy bans. There is no real difference between paying a woman to be a surrogate and paying a woman to carry an otherwise unwanted pregnancy to term in order to allow the child to be adopted. Both should be legal. And it’s likely to be hard to increase people’s willingness to donate this service, as we see in other cases of banned compensation for organ exchange, such as in the case of kidney donation. In combination with extracorporeal pregnancy technologies, I expect this would largely address the supply shortage.
Once the acute supply shortage is addressed by creating a “pregnancy profession,” you are faced with the problem of increasing the desire to rear children.
It’s not at all clear to me how supply and demand would scale with various subsidy measures and technological improvements, but one thing I am pretty confident about is that, on its face and by empirical analogy with the case of kidney donation, voluntary abortion reduction sounds like about the least tractable approach for achieving the aim of scaling up the supply of children available to be adopted. But that’s a strictly epistemic disagreement, and if hard data, or a convincing mechanism, were available, I’d absolutely change my mind on this point.
Edit:
One further point is that if you’re trying to convince people to carry pregnancies they don’t want out of an altruistic spirit, then a natural next move is to encourage women in EA to have babies in order to give them up for adoption (if they don’t want to raise the babies themselves). We find it charming when EAs donate kidneys to strangers, and this seems no different—indeed, a donated kidney will not generate nearly as many QALYs as a newborn baby. I find myself uncomfortable even articulating this idea, but it does seem consistent with your proposal, and more tractable than trying to convince people not to terminate pregnancies they don’t want when they’re not ideologically subscribed to EA-style altruism. All aboard, next stop Crazytown!
It’s not too crazy; being a pregnancy surrogate is something women can get paid to do and doesn’t really require any altruism. This is for an IVF baby generally, not carrying a baby with your own genetic material. The demand for babies is real. Selling eggs or sperm to gay couples trying to conceive is similar.
Edit for numbers: I think in California people pay surrogacy agencies $70,000 for everything and the women who carry the babies get about half that amount.
I should have elaborated more upon why abortion’s scale implies that those who have intervened to reduce it thus far aren’t going about it very effectively, but I’ll let Toby Ord do it instead:
Cancer, in all its forms, kills 7.6 million per year, while spontaneous abortion kills 30 times this number (World Health Organization 2005). In 6 years, the Second World War killed approximately 60 million people, whereas spontaneous abortion kills more than 3 times this number every year. For supporters of the Claim there is little choice but to see it as one of the world’s greatest problems, if not the greatest problem.
The introduction to the Scourge ended with a practical conclusion:
> There was an overwhelming obligation on society to fight it. Other projects had to be put on hold and a major international effort dedicated to loosening the Scourge’s grip on humanity.
For supporters of the Claim, it is difficult to resist a similar conclusion. Finding a means of saving even 5% of embryos from spontaneous abortion would save more lives than a cure for cancer. If we see one of these as requiring an immense international collaboration, then why not the other?
Toby’s argument is about spontaneous abortion’s neglectedness, not induced abortion, but it’s easy to divide the number by 3 (200 million → 73 million) and draw the same conclusion.
I don’t have strong disagreements with your policy prescriptions on adoption. Though you’ve retracted the crazytown comment, I’d also like to note that if (hypothetically) people who donated kidneys took 9 months to regenerate a new donateable kidney, then we’d see posts on the EA forum about how EAs should consider donating a kidney every year or so, and I’d largely agree with those posts.
On voluntary abortion reduction’s tractability, I think it’s worth pointing out that other problems of moral circle expansion including slavery, women’s rights, and hopefully animal welfare all began with voluntarily convincing people to do what was right, even in a time when few agreed. 150 years ago, slavery was widely practiced by many “civilized” countries. I don’t think it’s impossible that in 150 years, abortion will be widely regarded as the worst moral catastrophe in history between human beings. If that day ever comes, it’ll because people were convinced to take a stand, one person at a time.
Again, I really don’t think you can draw conclusions about “effectiveness,” at least as defined as “seizing the lowest-hanging fruit,” by articulating the scale of the problem.
But one other way you might find leverage is by moving the medical ethics community to include miscarriages in mortality statistics. 50% of miscarriages are due to chromosomal abnormalities and occur during the first few months of pregnancy.
Right now, we have all kinds of med ethics concerns around the idea that it’s somehow unethical to give an “advantage” by genetic modification or selection of embryos. But if we viewed that embryo as a person, or a medical patient, it is consensus unethical to make medical decisions on behalf of the welfare of anyone except that patient. So you can then only consider the health of the embryo. As a happy consequence, you not only get moral grounds for embryo engineering for health, you also (from a population growth and maternal health perspective) get ~75% fewer miscarriages if this became a common practice.
While those against abortion have many resources in the US, I don’t think that’s true in much of the rest of the world. Maybe some parts of Latin America would be another exception, but outside the US the anti-abortion movement is pretty severely underfunded. So I think there is a lot of room for improvement (from an anti-abortion perspective) there.
Regarding adoption, it seems to me that voluntary abortion reduction is not likely to increase the number of people placed for adoption by very much. Even with involuntary abortion denial, the best research we have seems to indicate that most women denied abortions go on to raise the child themselves rather than placing it for adoption. I would guess that this would be even more so if they are voluntarily choosing to continue the pregnancy. Most of these children have perfectly reasonable mental health outcomes. So it seems implausible that this would significantly counterbalance or outweigh the value of the extra lives preserved by voluntary abortion reduction interventions.
Here, I’m going to make a counterargument from a purely practical consequentialist perspective, without addressing your moral argument about the potential moral patienthood of the fetus or the moral urgency of increasing population growth.
I doubt that voluntary abortion reduction is a particularly tractable and neglected way to increase short-term population growth. Pew Research has a chart on the stances of major world religions on abortion, and most Christian churches, as well as Hinduism, are against. In other words, there’s already a lot of “abortion reduction” activity, using stronger measures than nice, voluntary persuasion.
Guttmacher Institute gives reasons why US women have abortions:
This is also true globally:
So with abortion reduction, the pregnant women you’re targeting are:
Already facing the cost of carrying a pregnancy they don’t want to term
Don’t want the baby
Won’t realize any substantial benefit from having the baby
Are probably in a pretty fraught position in their lives in many cases
And you are trying to somehow convince them to carry that baby to term voluntarily so that someone else can enjoy the benefit. That sounds intractable. On top of that, we have to point out that this is an enormously politically charged issue. Those who are against abortion already have massive resources aimed at abortion reduction. Among pro-choice people, arguing for the moral urgency of reducing abortions is going to create a lot of political friction. I think that’s something we have to take into account from a sheer, practical tractability standpoint.
With 73 million abortions, only about 250,000 children are adopted annually worldwide, even though globally, 10 million children live in institutions, and 60 million on the streets. There are about 2 million people waiting to adopt in the USA. I’m not sure how many people want to adopt globally, but my guess is that overall, there’s only enough potential adoptive parents to provide homes for a small fraction of the children who’d be born if more parents chose adoption rather than abortion. What fraction of voluntary abortion reduction resulting in the child being raised in an institution or on the street would we consider an acceptable outcome?
I’d be tentatively more comfortable with measures taken to facilitate increasing the number of wanted pregnancies, including legalizing paid surrogacy services and subsidizing childcare and adoption of older children. Bans on paid surrogacy are connected to a broader, and in my opinion, deeply unethical and massively impactful ban on the voluntary sale, or in this case rental, of one’s own organs.
I’ve focused on this topic more in the context of kidney sales. There, the public is generally quite supportive of a government-paid option for kidney sales, and most healthcare providers support a trial of a compensation mechanism. You’d never know it from media coverage, though, because a small group of sophisticated political and religious operatives have managed to create a false impression of an ethical consensus against kidney sales. I would not be surprised if legalizing paid surrogacy has even higher levels of public support. That is what I’d lean into if this was my issue.
Great counterpoints! I don’t disagree with many of your conclusions, although I have a few nitpicks.
I think voluntary abortion reduction may be more neglected than you seem to imply, if we define neglected as “neglected by effective interventionists.” Since there remain more abortions per annum than deaths by all causes put together, it seems that “abortion reduction interventionists” aren’t doing a very good job. Similarly, there are many “global poverty interventionists” who don’t seem to be very effective, given that GiveWell has found interventions which are many times more effective than the mean, so we might call global poverty neglected the same way. So I think there’s an important sense in which voluntary abortion reduction is neglected—by effective interventionists.
On adoption, I agree with you that there’s only so many children the world’s adoption infrastructure can absorb, let alone deliver them to good parents who would lead them to thriving lives. However, it seems like improving this system’s efficiency (would-be adopters in the US probably shouldn’t have to wait as long or pay as much as they do to adopt) and improving the culture around adoption would be a good idea even if it would be unrealistic for the infrastructure to ultimately scale enough to efficiently handle every child in need.
I agree completely with your policy recommendations on surrogacy and organs.
We can’t measure the success of an intervention by measuring the scale of the remaining problem. We need a reason to think that abortion activists are either ineffective or under-resourced, and given that the legality of abortion is trending downward both in the United States and globally despite rising trends in secularization, that just doesn’t seem plausible on its face. Furthermore, unlike many other charitable donors, anti-abortion activists really are primarily concerned with decreasing the number of abortions—and they’re willing to embrace all methods for doing so, including politics and even terrorism. “Voluntary abortion reduction,” honestly, sounds like one of the least effective means for achieving the aim of reducing abortions, although I could certainly be persuaded that I’m wrong on that point with data.
I want to point out that in the short run, we should actually have would-be adopters pay more and wait longer, because right now, the waiting list is enormous, and it never makes sense to address a shortage by subsidizing demand. It would probably be best if the money they pay went to the women who are having the children, even if by an indirect mechanism.
In the long run, if you did manage to eliminate the waiting list by increasing the production of children for adoption then yes, you would eventually run into the opposite need, to subsidize childrearing. But that cuts against your abortion-reduction cause.
Effectively, my model from a population-growth standpoint is this:
We have an acute child-supply shortage due mainly to paid surrogacy bans. There is no real difference between paying a woman to be a surrogate and paying a woman to carry an otherwise unwanted pregnancy to term in order to allow the child to be adopted. Both should be legal. And it’s likely to be hard to increase people’s willingness to donate this service, as we see in other cases of banned compensation for organ exchange, such as in the case of kidney donation. In combination with extracorporeal pregnancy technologies, I expect this would largely address the supply shortage.
Once the acute supply shortage is addressed by creating a “pregnancy profession,” you are faced with the problem of increasing the desire to rear children.
It’s not at all clear to me how supply and demand would scale with various subsidy measures and technological improvements, but one thing I am pretty confident about is that, on its face and by empirical analogy with the case of kidney donation, voluntary abortion reduction sounds like about the least tractable approach for achieving the aim of scaling up the supply of children available to be adopted. But that’s a strictly epistemic disagreement, and if hard data, or a convincing mechanism, were available, I’d absolutely change my mind on this point.
Edit:
One further point is that if you’re trying to convince people to carry pregnancies they don’t want out of an altruistic spirit, then a natural next move is to encourage women in EA to have babies in order to give them up for adoption (if they don’t want to raise the babies themselves). We find it charming when EAs donate kidneys to strangers, and this seems no different—indeed, a donated kidney will not generate nearly as many QALYs as a newborn baby. I find myself uncomfortable even articulating this idea, but it does seem consistent with your proposal, and more tractable than trying to convince people not to terminate pregnancies they don’t want when they’re not ideologically subscribed to EA-style altruism. All aboard, next stop Crazytown!
It’s not too crazy; being a pregnancy surrogate is something women can get paid to do and doesn’t really require any altruism. This is for an IVF baby generally, not carrying a baby with your own genetic material. The demand for babies is real. Selling eggs or sperm to gay couples trying to conceive is similar.
Edit for numbers: I think in California people pay surrogacy agencies $70,000 for everything and the women who carry the babies get about half that amount.
That is a fair point actually! I retract my crazytown comment.
Thanks for your reply!
I should have elaborated more upon why abortion’s scale implies that those who have intervened to reduce it thus far aren’t going about it very effectively, but I’ll let Toby Ord do it instead:
Toby’s argument is about spontaneous abortion’s neglectedness, not induced abortion, but it’s easy to divide the number by 3 (200 million → 73 million) and draw the same conclusion.
I don’t have strong disagreements with your policy prescriptions on adoption. Though you’ve retracted the crazytown comment, I’d also like to note that if (hypothetically) people who donated kidneys took 9 months to regenerate a new donateable kidney, then we’d see posts on the EA forum about how EAs should consider donating a kidney every year or so, and I’d largely agree with those posts.
On voluntary abortion reduction’s tractability, I think it’s worth pointing out that other problems of moral circle expansion including slavery, women’s rights, and hopefully animal welfare all began with voluntarily convincing people to do what was right, even in a time when few agreed. 150 years ago, slavery was widely practiced by many “civilized” countries. I don’t think it’s impossible that in 150 years, abortion will be widely regarded as the worst moral catastrophe in history between human beings. If that day ever comes, it’ll because people were convinced to take a stand, one person at a time.
Again, I really don’t think you can draw conclusions about “effectiveness,” at least as defined as “seizing the lowest-hanging fruit,” by articulating the scale of the problem.
But one other way you might find leverage is by moving the medical ethics community to include miscarriages in mortality statistics. 50% of miscarriages are due to chromosomal abnormalities and occur during the first few months of pregnancy.
Right now, we have all kinds of med ethics concerns around the idea that it’s somehow unethical to give an “advantage” by genetic modification or selection of embryos. But if we viewed that embryo as a person, or a medical patient, it is consensus unethical to make medical decisions on behalf of the welfare of anyone except that patient. So you can then only consider the health of the embryo. As a happy consequence, you not only get moral grounds for embryo engineering for health, you also (from a population growth and maternal health perspective) get ~75% fewer miscarriages if this became a common practice.
While those against abortion have many resources in the US, I don’t think that’s true in much of the rest of the world. Maybe some parts of Latin America would be another exception, but outside the US the anti-abortion movement is pretty severely underfunded. So I think there is a lot of room for improvement (from an anti-abortion perspective) there.
Regarding adoption, it seems to me that voluntary abortion reduction is not likely to increase the number of people placed for adoption by very much. Even with involuntary abortion denial, the best research we have seems to indicate that most women denied abortions go on to raise the child themselves rather than placing it for adoption. I would guess that this would be even more so if they are voluntarily choosing to continue the pregnancy. Most of these children have perfectly reasonable mental health outcomes. So it seems implausible that this would significantly counterbalance or outweigh the value of the extra lives preserved by voluntary abortion reduction interventions.