Father Robert Drinan addressed my medical school class several months before the Supreme Court decision in Roe v. Wade.  He was a soft-spoken, modestly dressed Jesuit priest, who was invited to discuss with us and a patient, whom I shall call Mary, a distinctly spiritual dilemma.  Mary had already had eight children.  All of them had died early in infancy from cystic fibrosis. She was pregnant for the ninth time, and the fetus was positive for cystic fibrosis. Given the absence of any useful treatments for children born with the virulent form of cystic fibrosis that Mary’s children had and given the inevitability that she would bury her ninth child if her pregnancy continued to term, Father Drinan was called in for spiritual guidance.

By the time she had this ninth pregnancy, Mary was in tenuous shape. She was physically spent.  The pregnancies had been occurring almost once a year, and in most of the prior nine years, she had been caring for a dying infant while carrying a doomed fetus. Genetic counselors had advised her that her probability of having a child with cystic fibrosis was only one in four. This meant that the probability of having nine pregnancies in a row with fetuses affected by this genetic disorder was 1 in 262,144, and so she kept trying (and failing) to have a healthy child. The prospects for innovative treatments that might save her ninth child were nil. Because of her religious beliefs, she refused to practice birth control. Because of her religious beliefs, she felt she needed to complete this pregnancy before trying to have a healthy child for the tenth time. Father Drinan embraced her, advised her that her religion did not require her to carry the doomed fetus to term, and assured her that he would be there to help her bear any burdens she might face in the future.  Mary had an abortion. Father Drinan was threatened with excommunication if he continued his heretical teachings.

What I remember most clearly about Father Drinan, aside from his being an ideal candidate for sainthood rather than excommunication, was his religious argument. He reasoned (as Jesuit’s were encouraged to do) that if abortion was an obvious evil, his God would not perform so many.  He noted that more than a third of pregnancies ended in miscarriages, a figure that still is fairly accurate. A miscarriage is nothing more than a spontaneous abortion. For innumerable reasons, and in many cases for no apparent reason at all, a pregnancy would end and a fetus would be expelled from the womb before the fetus had any chance for survival. Mother Nature obviously had her reasons for this frequent rejection of this “potential person,” but she rarely shared her rationale with us. Recent statistics indicate that about 30 % of all pregnancies will end in spontaneous abortions, most occurring before 28 weeks after fertilization of the egg by the sperm, and that does not include stillbirths, babies who appear to be alive until just before their deliveries.

The aboriginal Australians, identifying themselves as Yolngu and as Murngins by European anthropologists, held complex religious beliefs prior to their contact with Europeans, especially with regard to the unborn. The environment they struggled to survive in required harsh measures to control their population growth.  When resources became barely sufficient to support their current population, they would resort to induced abortions to avoid starvation. According to their religious beliefs, the spirit of the aborted fetus would transfer to the developing body of a future fetus. No souls were lost, and no children would starve to death. Other religions have insisted on other types of re-incarnation, but most currently practiced religions still view the soul or spirit of a person as distinct from the flesh that he or she inhabits.

What religious view should prevail is not an issue of law in the United States since the First Amendment to the Constitution addresses and supports the separation of church and state. Whether you believe in the fetal transfer of souls or the establishment of a human being when the paternal sperm enters and fuses with the maternal egg is a matter of personal belief that cannot be settled by scientific argument or legislation. As we learn more about why God, the gods, Mother Nature, or the Benign Indifference of the Universe commits abortion so frequently, we may be able to limit or avoid this outcome, but that will not have any substantial impact on individual views on pregnancy termination. The decision in Roe v. Wade was not that abortion was good or bad, right or wrong, but rather that it was a medical procedure, the appropriateness or necessity of which should be and must be left to a woman in consultation with a licensed physician. In fact, the majority decision emphasized the privacy issues involved with regard to both the physician and the woman involved in making this decision. It did not and dared not tread on the ethical issues.

There is no scientific basis for determining when we should declare a clump of cells an embryo or when an embryo is adequately developed to be designated a fetus or when a fetus is adequately developed to be considered a person. All of these labels are based upon arbitrary designations, designations on which even scientists routinely disagree. Few fetuses less than 25 weeks from the date of fertilization will survive outside the womb with currently available techniques, and most of those that do survive have severe neurologic deficits. Ironically, our ability to clone animals, including humans, is progressing rapidly, and we may soon face the dilemma of wealthy individuals choosing to ‘raise’ innumerable copies of themselves in armies of surrogate mothers.  Can we insist that they dispose of these cloned embryos and fetuses while threatening with prison the pregnant high-school girl who tries to get rid of the product of an ‘inconvenient’ [as described by one U.S. Senate candidate from Texas] date rape?

Billions of cells from any person on earth are suitable for cloning, and the religious views of some may inspire them to try to perpetuate a humanity based on their own genetic make-up. John D. Rockefeller Sr. admitted to being amazed by his own financial success and concluded that his boundless good fortune (and good health) could only be explained by a Divinity that had chosen him as the standard bearer of the Correct Choices.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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