Head vs. Heart in the Abortion Debate
An abortionist defends her practice; two philosophers defend the fetus.

Reviewed by Emily Bazelon
Sunday, January 20, 2008


My Journey as an Abortion Doctor

By Susan Wicklund

Public Affairs. 268 pp. $24.95


A Defense of Human Life

By Robert P. George and Christopher Tollefsen

Doubleday. 242 pp. $23.95

In the 35 years since Roe v. Wade, human stories and hard science have been the dueling weapons of the abortion wars. Abortion opponents have presented emotional accounts of the destruction of fetuses -- and, more recently, tales of distress from women who regret their abortions. Supporters of legal abortion have often countered with data on the decline in backstreet abortions and improvements in women's health and welfare.

So it's a welcome change to see two new books in which the pro-life and pro-choice camps switch their usual tactics. In This Common Secret, Susan Wicklund tells riveting stories about patients she has treated during nearly 20 years as an abortion provider. Meanwhile, in Embryo, Robert P. George and Christopher Tollefsen argue on scientific and philosophical grounds that from its first moment as a one-cell organism, the embryo is a living human being and, thus, entitled to legal protection. If Wicklund's book is the more effective, perhaps that's because she's not claiming to prove one objective truth, just conveying her own experience -- and because she has good, multifaceted stories to tell.

As a 26-year-old single mother working part-time and getting by on welfare and food stamps, Susan Wicklund became one of the first members of her large Wisconsin family to go to college. Before she decided to become a doctor and specialize in women's health, she had her own abortion to surmount -- a 1976 procedure that she did not understand, and that she sobbed and fought her way through until a doctor told her to shut up and drugged her. This horror story could come straight out of an anti-abortion pamphlet were it not for the determination Wicklund drew from it as she began medical school: "I could make sure my patients were treated differently than I had been -- with respect and decency. The memory of my own abortion troubled me, but it also hardened my resolve."

Such clear-eyed depictions of abortion services, and the close-up descriptions of the women Wicklund has treated, are the source of the book's power. This is a doctor who spent years working 100-hour weeks, crisscrossing the West to reach remote clinics and pregnant women. Over the years, Wicklund endured stalking and physical threats. She wore a bulletproof vest and carried a gun. One desperate morning in 1991, she woke to the sound of protesters chanting, "Susan kills babies!" outside her rural home. They stayed for weeks; Wicklund's daughter had to ride to school in a police car. And her marriage fell victim to the work and strain. "I have to recognize the truth," she writes. "My commitments have demanded a great deal from the people I love."

Her zeal is not for simple abortion on demand, but for medical care that ends in abortion only when both doctor and patient are sure of that choice. "My biggest fear has always been to do an abortion on someone who will later come to regret it," she writes. When she is afraid a woman is being coerced or has doubts, Wicklund says, she sends the woman away. In her book, Wicklund prints a grateful letter from one such patient. And she tells the story of a patient who opted for abortion because she'd thought she'd conceived through a rape, only to grieve inconsolably when she realized she'd mistaken the timing of her pregnancy.

These are not typical stories, and Wicklund does not present them as such. But she uses them to underscore the importance of counseling, which she describes as the biggest economic challenge of abortion practice, since it's hard to recoup the costs from insurers. And Wicklund's sensitivity to the fraught nature of abortion, as some women experience it, makes her stories of the damage wrought by the "antis," as she calls them, more credible and vivid. On the satisfied customer side of the ledger, she counts a prim woman who let loose a terrific scream of joy when assured she was no longer pregnant. And to illustrate the hassle of state-imposed restrictions, Wicklund describes a teenager who missed days of school and had to wait a month because of a state parental consent law, and a woman who lost her job because of the multiple visits necessitated by a mandated 24-hour waiting period.

George and Tollefsen's prose is dryer than Wicklund's because of the nature of their project. The authors -- George is a Princeton professor of jurisprudence and member of the President's Council on Bioethics, and Tollefsen a philosophy professor at the University of South Carolina -- set out to prove that "a human embryo is a whole living member of the species Homo sapiens in the earliest stage of his or her natural development." As such, from the moment of fertilization, the embryo deserves full moral respect as well as "the rights that people possess simply by virtue of their humanity." George and Tollefsen deliberately set aside religion in making their case, relying instead on the classic tools of philosophical proof.

The first steps of their argument are fairly unassailable -- sperm fertilizes egg, and a pencil-point-sized embryo, or zygote, is formed "fully programmed" to become a baby nine months later (assuming no missteps along the way). But can science or philosophy prove that this zygote has the same moral claim to legal status as any member of the "human family," such that the destruction of embryos in the service of stem cell research is akin to Nazi experiments on the mentally retarded?

The "living Homo sapiens" language that George and Tollefsen defend has been adopted by the legislature of South Dakota and is the subject of a legal challenge that may end up before the Supreme Court. The judges who have ruled in the case so far reject the notion that the status of the embryo can be objectively resolved by science. George and Tollefsen's book probably won't change their minds.

Here's an example that illustrates why. Harvard professor Michael Sandel, one of the authors' academic sparring partners, has posed this hypothetical: Suppose you're escaping from a building that's on fire, and you have to choose between saving a crate of frozen embryos and a 5-year-old girl -- which do you rescue? George and Tollefsen have to admit that most people would save the girl. But they insist that if the rescuer were the parent or grandparent of the embryos, he "might well choose to rescue them, and most people would not regard this as immoral."

Really? Is this an accurate representation of the moral stance of "most people," or a mirror that George and Tollefsen are holding up to themselves? Last fall, scientists in the United States and Japan announced they had reprogrammed adult cells to give them the qualities of embryonic cells that are so valued in stem cell research. This development takes the urgency out of George and Tollefsen's plea -- and most people would probably agree that if it leaves us with less to fight over in this arena, so much the better. But if science helps ease the embryo debate, it will be for reasons that these authors don't anticipate. *

Emily Bazelon is a senior editor at Slate.

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