Ultrasound before Abortion: Consideration of Recent Research–Closing Comments

In my previous two posts (April 22 and April 29) I discussed an article in the January edition of Obstetrics & Gynecology entitled, “Relationship Between Ultrasound Viewing and Proceeding to Abortion.” The authors found that in Planned Parenthood clinics in LA, the voluntary viewing of ultrasounds by patients seeking abortions appeared to dissuade a very small percentage from continuing on to abortion. From their data the authors concluded that women should not be required to view ultrasounds prior to elective abortions. They state that, “…because fewer than half of women select this option, mandatory viewing “may have negative psychological and physical effects even on women who wish to view.”

Three points regarding the authors’ ethical calculus: First, their equation is incomplete; second, to weigh “effects” we must be more precise in what they are; third, they fail to describe the one group of people who ought to be doing this ethical calculation, but are not.

First, this article certainly does not weigh all the adverse psychological and physical consequences involved in the act of abortion, or even all the consequences—good or bad—of mandated ultrasounds. It is premature, therefore, on the basis of this study to argue that they are either harmful or beneficial psychologically or physically. The authors make no mention of the possibility that harm or benefit of one’s actions may proceed well into the future, or of the possibility that simply because there is “certainty” regarding abortion that the decisions are informed, or not coerced.

Second, the authors cite “negative psychological and physical effects,” but this is a most imprecise description—by design, I believe. What are these untold effects but modern society’s taboos of guilt and regret? These words must not be spoken of by those in favor of abortion because they would remind of us of right and wrong existing beyond personal choice. Guilt and regret, after all, do not spring de novo. They are born of some sense of wrongness, and point to values beyond simple autonomy. To hold to the thin reed of “choice”, however, one must disallow discussion beyond “psychological and physical effects.” But this blinds us to the existence of a greater morality than individual choice, and therefore to the reality of the human condition.

Finally, in this research the focus on whether or not women changed their mind after viewing their ultrasound or even desired to view it at all fails to acknowledge that there is one group of moral agents whose decision-making is central to the issue of abortion, including to the decisions of the women themselves: physicians. As Justice Blackmun stated in Roe v. Wade’s majority opinion, “the abortion decision in all its aspects is inherently, and primarily, a medical decision, and basic responsibility for it must rest with the physician.” A reading of the subsequent opinion will show that this medical decision-making is ultimately a moral endeavor. But where is the physician in this article’s abortion process? Where is the seeking of each patient’s story, fears, concerns, goals, needs, and so on, that are all necessary for rendering a proper “medical” (but truly moral) decision? In pro-abortion arguments, no allowances whatsoever of physician judgment are allowed to eke into the discussion, yet the Supreme Court justified the legality of abortion on its active (and determinative) role in each decision to abort.

This “medical” decision is supposed to have a certain inherent moral authority, or imprimatur, born of the professional judgment and obligations of physicians. If such individualized contemplation regarding each procedure of abortion is not modeled by those medical professionals whose careers ostensibly carry the moral credentials stemming from caring for others, then there is no surprise when a woman in crisis does not reach a moral epiphany that directs her to the exit. It is sad that our society, which once had a physician profession that was firmly and universally dedicated to the well-being of the unborn, now senses some need to get moral awareness awakened by some other means. The problem, then, wasn’t that the women viewing the ultrasounds failed to change their minds, it’s that the physicians performing them didn’t.


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Susan Haack

Thanks for your thoughtful evaluation. I have wrestled with this issue; your assessment was very helpful.