An Overdue Life-and-Waste Discussion

"There's a middle group that, if there was anybody interested in organizing them, could probably mediate some of the stuff at the far ends of both spectrums."
"It wouldn't make everybody happy. But nobody is happy now, anyway."
"People on both sides of the issue are nervous about speaking about things that are ethically complex, because how will those things be used by people on the other side. Those of us who are pro-choice present pro-lifers as adamant -- 'no abortion for any reason, just let the woman die'. [Whereas pro-lifers think of pro-choice people believing abortion not the delivery room is entirely acceptable.] Neither of these things is true."
"There are reasons women have abortions, and if those reasons didn't exist, many of them would continue their pregnancies."
Frances Kissling, president, Center for Health, Ethics and Social Policy, Washington

"Outside of a fraction of the country, the abortion issue, on the whole, as a medical transaction, seems done."
"[The issue behind abortion acceptability presents] a quandary that now puts abortion in the realm of the assisted dying debate."
"We are past the stage of whether or not we should have the moral, ethical, legal and legislative right [to a doctor-assisted departure from this world]. On that issue, we're now into the weeds of deciding the final what and when. And that's comparatively where the abortion issue is now."
John Write, pollster, DART & Maru/Blue polling

"[There exists a lack of nuance in public debates on abortion] because of the kinds of questions too often asked in public polls on abortion. Questions that aren't meaningful to the lives of people most directly affected."
"[A minor with an unwanted pregnancy and unsupportive parents in parental consent can be asked an opinion and] one would likely get a very different answer than from a random poll."
"A meaningful question about abortion later in pregnancy would ask about the reasons why people seek and need abortion through pregnancy, and about the hardships endured, the resources required and the stigma suffered by many in accessing this care."
Joanna Erdman, associate professor, Schulich School of Law, Dalhousie University

New technologies are pushing the boundaries of “fetal viability,” and challenging our ideas about confronting us with discomforting questions about abortion.   Getty Images

Hospitals and clinics in Canada performed slightly over 85,000 abortions in 2018, according to the Canadian Institute for Health Information; a lower number than was done in 2017, at 94,000 when the abortion drug Mifegymiso was available in Canada, when women could abort in the privacy of their homes. The two-pill regimen can be prescribed within the first nine weeks of pregnancy, where a normal full-term is roughly 40 weeks.

A fetus cannot breathe outside its mother's body at 21 weeks; the tiny sacs called alveoli that fill with oxygen are not yet fully developed; premature lungs lack surfactant to keep the tiny air sacs from collapsing and sticking together when deflated. Yet the near future holds out the possibility that a fetus could be placed within an artificial womb, a translucent, plastic vessel filled with fluid mimicking the uterine environment. An oxygenator powered by fetal heartbeat,

In such a scenario an "extracorporeal" uterine device would nurture a viable human fetus enabling it to grow, bathed in artificial amniotic fluid until such time as the lungs, brain and other organs mature, technicians keeping watch while the sounds of a maternal heartbeat soothe the fetus. The greater majority of Canadians believe abortion should not be legal past the initiation of the third trimester of pregnancy -- 28 weeks onward.

There is a middle group identified by an extensive national survey of Canadians with more nuanced views on abortion than the committed pro-lifers and -choicers. A recently published DART & Maru/Blue poll found seven in ten Canadians think of the current situation on abortion, with no legal restrictions at any stage of pregnancy acceptable. Decades ago an earlier poll indicated that 44 percent of people surveyed believed abortion should be legal in some circumstances, with 32 percent saying when the woman wanted it, and 22 percent that it be prohibited unless the mother's life was in danger.

The current DART poll found one in ten considers abortion unacceptable; the majority -- 71 percent -- feel a woman should have access to an abortion once she decides she wants to have it, irrespective of reason. Yet a deeper issued revealed itself when the survey highlighted areas of ethical and moral debate where, though two-thirds (62 percent) of Canadians led by Quebec and British Columbia, identify primarily as pro-choice, and only one in ten as pro-life (led by Alberta, at 19 percent), one quarter of Canadians felt uncomfortable in either category.

Of those, three-quarters believe an abortion should be legal when evidence exists that the fetus may be mentally or physically impaired, while six in ten believe abortion should be legal if the woman or family is unable to raise the child affordably. Canadians believe almost unanimously (93 percent) that doctors should be lawfully required to inform women of potential risks of surgical abortion prior to the procedure. Over three-quarters favour a law that would require doctors to inform women about abortion alternatives, like adoption.

A law requiring women seeking abortion to wait 24 hours between counselling and committing to the procedure is favoured by two-thirds of respondents, while half believe a law should require women under 18 to have parental consent for an abortion, and seven in ten feel abortion should be illegal in the final three months of pregnancy. And while a dominant majority reject abortion outright for sex selection -- usually favouring males -- only 57 percent believe abortion should be legal in the second trimester.

As to the question whether government should debate the issue of abortion, three-quarters of respondents feel matters would best be left as they are, yet the status quo reflects that Canada is alone in the world with no legal boundaries on abortion even while half of Canadians feel politicians should at the very least be willing to discuss providing some regulatory framework. The extremes on both sides of the issue, points out Ms. Kissling, a pro-choice Catholic herself, control the politics in their entrenched warfare, paying no mind to moral complexities, reducing the debate to absolutist positions.

A team at Children’s Hospital of Philadelphia is developing a “Biobag,” or artificial womb-like device, to help keep babies born severely premature alive. Children’s Hospital of Philadelphia