The end of a life: One doctor’s view of abortion

As a physician, I consider my essential role to be prolonging life and relieving suffering. I am bound by the oath of the great rabbi, prophet and physician Moses Maimonides, who said that he sees in a patient nothing more than a fellow creature in pain.

This is why I was so disturbed this past week to see a close relative of mine, paralyzed and semi-comatose in an ICU, continue to be poked and prodded while remaining hooked to a ventilator despite clear continued suffering and zero quality of life.

Conversely, I am forced to contrast that in my mind with the reaction to the Supreme Court’s ruling on Roe v. Wade, a decision that at least some legal scholars believe was based on a strict interpretation of the Constitution, which, they argue, does not give a woman — or her doctor — an automatic right to perform an abortion procedure.

I confess I can see both sides of this. I have seen abortions performed on women whose lives, I knew, would have been ruined if they had kept the children and at least as many who weren’t counseled properly and who regretted their decisions afterward and for the rest of their lives. I understand that Roe was based on public health data of women who had dangerous abortions performed illegally because they had no way to have them, but, at the same time, I am swayed by the words of Ben Carson, the great neurosurgeon-turned-politician, who told me in an interview a few years ago that once he had operated on a fetus and saved it, he could never again see a blastocyst as simply a clump of cells.

My religion does not assert that life begins at conception, though at some point a fetus does become a viable being. Exactly when that point — viability — is reached has continued to be the subject of much debate, and medical technology has altered our perceptions since 1973, when the court handed down its Roe ruling. 

Ultrasound shows us a formed fetus with a beating heart in the first trimester, while, at the same time, the abortion pill RU-486 has provided doctors and their patients since the 1980s with the opportunity to induce abortion without a surgical procedure for up to 13 weeks; that now accounts for more than 50 percent of abortions. I am OK with this, though I have never prescribed it. 

Meanwhile, so-called viability, by which you can keep a premature baby alive in a neonatal ICU, becomes earlier and earlier in the second trimester (23 or 24 weeks). I am definitely not comfortable with abortions performed beyond this point during a pregnancy except for strict medical purposes. 

I don’t know where I stand overall on abortion, although, as a non-obstetrician physician, I don’t feel comfortable with the idea of performing one myself, a position I believe should be respected. At the same time, I do not believe physicians should be prosecuted for performing one.

One thing I am certain of ethically is that an abortion should never be performed based on convenience or because of external pressures on a woman or because a woman cannot afford to raise the child. A woman is in charge of her body, including and especially when pregnant, but, at some point, the growing life in the womb must be considered too. 

Consider that we live in a country where hospitals spend millions of dollars each day keeping alive people such as my relative, who has no viability beyond artificial life support. Certainly we can extend that courtesy to an unborn child who hasn’t seen life outside of the warmth of the womb.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”

Tags Abortion Abortion debate Ben Carson Dobbs v. Jackson Women's Health Organization Ethics Fetal viability Fetus Marc Siegel morning after pill Roe v Wade

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