Third trimester abortion: is compassion enough?

Br J Obstet Gynaecol. 1999 Apr;106(4):293-6. doi: 10.1111/j.1471-0528.1999.tb08264.x.


PIP: One comprehensive ethical framework that can be applied to cases of third trimester abortion is based on the following notion: patient trust depends upon physicians developing specific virtues and basing their professional actions on these virtues. One such virtue, as described by Dr. John Gregory in 1772, is sympathy for the distress of others that overcomes self-interest. This application of sympathy and desire to relieve suffering can justify late term abortion in some cases. The compassionate response to sympathy forwarded by Gregory, however, must be properly regulated by reason, as Gregory himself recognized. Thomas Percival (1740-1803), author of the classic text "Medical Ethics," charged physicians with uniting "tenderness" (Gregory's "sympathy") with "steadiness." This combination of virtues reoccurs in the contemporary work of bioethicists Edmund Pellegrino and David Thomasma. The intellectual component of compassion requires physicians to exhibit compassion towards their patients, and this includes fetal patients. Thus, third trimester abortion is only justified in cases where fetal abnormalities are associated with the certainty or near certainty of early death or of a complete absence of cognitive developmental capacity. Most anomalies fail to meet these criteria, and physicians must exhibit the virtues of self-effacement and integrity to make rigorous, clinical, ethical judgements and properly balance the interests of the pregnant woman and the fetus.

MeSH terms

  • Abortion, Induced*
  • Congenital Abnormalities*
  • Ethics, Medical*
  • Female
  • Humans
  • Physician-Patient Relations
  • Pregnancy
  • Pregnancy Trimester, Third