By Wesley J. Smith
The Journal of Medical Ethics is one of the preeminent bioethics journals in the world. So, when an article appears in the publication that is subversive to human decency and basic morality, notice needs to be taken.
“Is pregnancy a disease?” the article’s title asks. Why yes, yes, it is, the authors answer.
First, they depict pregnancy as if the gestating baby were a tumor:
Imagine a patient who visits the doctor having an abdominal mass that is increasing in size, causing pain, vomiting and displacement of other internal organs. Tests are booked, and investigations are planned. But when the patient mentions that she has missed her period, these alarming symptoms suddenly become trivial. She is pregnant!
The authors don’t care that pregnancy is a normal part of life and necessary for the human race to continue. Rather, they compare being with child, as the old saying went, to contracting the measles:
We can compare pregnancy with measles. Measles is uncontroversially regarded as a disease and treated as such by public health authorities and health professionals. Measles is harmful to nearly all of those who catch it. However, most patients will survive. Very few will die, and only a small proportion will go on to experience longer term impacts on their health. So how do the risks of pregnancy compare against those of measles?
Like measles, pregnancy is a self-limiting condition. It follows a predictable trajectory that usually ends in the patient’s recovery. Both pregnancy and measles also involve symptoms that can impair one’s normal functional ability. Common symptoms experienced during pregnancy include: back pain, bleeding gums, headaches, heartburn and indigestion, leaking from the nipples, nosebleeds, pelvic pain, piles, stomach pain, stretch marks, swollen ankles, feet and fingers, tiredness and sleep problems, thrush, vaginal bleeding, vaginal discharge, vomiting, morning sickness and weight gain. Like many diseases, including measles, pregnancy is a condition that has distinct stages. The first stage of pregnancy commonly involves many of the symptoms described above. The second stage—labour—will usually involve extreme pain, powerful cramps, and the ripping, stretching and damaging of tissue. This second stage is far riskier than the first, in terms of long-term threats to life and health.
In other words, the developing child is the equivalent of a pathogen.
But isn’t pregnancy a normal part of human life? No! Because most people can’t get pregnant — i.e., males and females not of child-bearing age:
Currently, there are approximately 1.8 billion such women [of child-bearing age] in existence. But there are only around 211 million pregnancies yearly. Thus, the norm for people in this group is not to be pregnant. Based purely on numbers, pregnancy is abnormal, even within the narrowest target group we can define. So can we really insist that pregnancy constitutes ‘normal species function’ when most of the people in the target group are not pregnant?
Oh, the sophistry!
Furthering their thesis, the authors claim that childbirth is so traumatic, humans may one day go extinct:
We are a species that has been around for an extraordinarily short period of time in evolutionary terms. Human childbirth is significantly more painful, protracted, and lethal than delivery in other mammal species. As noted, gender equality leads to plummeting birthdates, perhaps precisely because human birth is so traumatic for the human body, and is incompatible with many other goods that humans value. We cannot infer from our existence now that we are equipped to survive indefinitely, nor that reproduction will continue as we know it.
But what about infertility? The inability to conceive is treated as a disease — even for same-sex couples — access to the “treatments” for which (i.e., IVF, surrogacy, etc.) is becoming a civil right.
So, the cure for the one disease is to give the woman a different disease? No. Suddenly, infertility is not a disease!
Infertility is treated as a disease not because of its objective physiological or scientific features, but because of social norms that incline us to think people should have children.
Please. Infertility is treated as a disease — at least among heterosexual couples of child-bearing age — because the inability to get pregnant is considered a bodily dysfunction. In contrast, conceiving is a healthy biological process.
The authors claim that treating pregnancy as a disease will be good for women because medical means to prevent — or terminate — pregnancy will be considered preventative treatment:
Pathologising pregnancy could, in fact, lead to better treatment for women. If pregnancy is construed as a disease and access to contraception and abortion as preventive medicine, it puts the provision of these interventions on a different footing. This is not about ‘family planning’ or reproductive autonomy, but about medical need.
Readers may say to themselves, “So, who cares what a couple of silly bioethicists think?” Indeed, that was the very reaction of many readers when I began warning some years ago that bioethics discourse was promoting puberty blocking for gender-dysphoric children. Now, look at where we are.
Arguing that “pregnancy is a disease” and an unborn baby a pathogen would have a material impact on abortion policy. After all, what law can legitimately interfere with doctors “curing” a “disease?” More generally, the views expressed are consistent with the increasing anti-natalism seen lately in philosophy and bioethics. As such, it illustrates my thesis that the field is becoming increasingly anti-human.
Editor’s note. Wesley’s great columns appear at National Review Online and reposted with permission.