I know some that plausibly save tens or hundreds of thousands of lives a year on a very low budget, but they are quite low-key so it is hard to say more.
Highlighting the passage is perfectly fine - I wrote it, and it is part of the post. What is not fine is continually suggesting that it is the primary argument I have given for abortion being wrong, when that is manifestly not the case, and I have made that explicit. I'm happy to respond to criticisms of that particular point - but not for people to misrepresent my post by pretending that it is the main argument given, especially when I have clarified that it is not.
Yes, I am familiar with the evidence. If I had deliberately misrepresented any of the papers I cited, then again, you would be right. But you have failed to show that. Bockmann does think the fetus is likely conscious and able to feel pain by that point, even if they phrased it more hesitantly in the paper, presumably because it is difficult to be certain. Of course, we can never be certain - but they have shown that the main arguments for placing fetal consciousness later in pregnancy fail. I see no good reason to suppose it is later than 12 weeks.
Again, no, I did not 'just state' that we should 'assume' 4 week old fetuses have full human rights. I said, for example, "Denial of fetal personhood typically leads to implausible conclusions regarding how we may treat infants and severely disabled humans, and arguably to a denial of human equality even among non-disabled adults." These arguments apply to all embryos/fetuses, regardless of whether they can feel pain, and more detail is available in the references linked.
"Long science comment incoming: I’ve had some time to go over the literature, and I find the passage below (which is the main secular argument against abortion presented) to be highly misleading."
As I already explained in my comments above, the paragraph to which you refer was not the main argument against abortion, it was an extra peripheral consideration for a certain subgroup of readers. I do not understand why you seek to misrepresent my post even after I made this clarification.
"The mature brain cortex does not appear until week 24-ish, and according to this review paper , EEG results only produce reliable patterns synonymous with “wakefulness” at week 30, and at earlier dates the signal is often discontinuous. However, there is some research showing that cognition and experiences can occur without a fully formed cortex, so it should not be taken as the dividing line for certain.
(If you think I am cherry picking, these sources come from the first google scholar results for "fetal pain review")"
Yes, Lee's paper is well-known. But the wakefulness stuff is not really plausible - the RCOG dropped the argument completely from their recent review of the evidence, as Bellieni's recent response points out (https://onlinelibrary.wiley.com/doi/10.1002/ejp.2109) - as Derbyshire pointed out elsewhere, there are a number of problems with this argument, including the fact that we just don't really know much about the EEG sleep patterns even for newborns, let alone fetuses. We also have pretty clear ultrasonography from 23 weeks showing a fetus clearly crying in response to an anaesthetic injection - it is very implausible to me that this is done while asleep.
Regarding the rest: yes, the authors are somewhat cautious, though I'm pretty sure Bockmann now considers it likely the fetus can feel pain from 12 weeks, and I think is open to it being even earlier. The question is: is there any reason why the fetus wouldn't feel pain at that point? You might say 'because the cortex isn't fully developed'. But as the authors point out, there is reason to doubt the necessity of the cortex for pain perception. The wakefulness argument doesn't really work, for the reasons that Bellieni and Derbyshire describe.
"What the OP also didn’t mention was what the whole debate was mainly about: whether or not to use analgesia or anaesthesia when performing abortions. Even if an early fetus is capable of feeling pain, the use of these during the abortion may render the procedure painless."
No, this isn't what the debate is mainly about. I have made very clear in my comments I am also talking about early embryos/fetuses before pain capability, and that the arguments I describe briefly (and link to for more detail) apply to these.
These terms are pretty widely used and are the most widely accepted. Of course I don't think 'pro-choice' is a good, neutral term - but they are a reasonable compromise for the sake of clarity, since everyone understands what they mean.
I don't know what you mean here.
Yes, there is a lot we can do to tackle the root causes of abortion.
EA is supposed to consider how to improve the world as much as possible - that is what this post aims to do. The fact that it might lend credibility to a right-wing cause does not bother me, nor does the fact that the pro-animal posts here might lend credibility to a left-wing cause. I am struggling to understand what point you are trying to express, unless you are just assuming that anything that could benefit conservatives is evil. But that is just silly. Moreover, plenty of left-wing people (like myself) are opposed to abortion.
I explicitly stated at the start of that appendix that it was relevant for the 15% or so of EAs who are religious. It is relevant to them, and belongs there. If you don't like, scroll past it.
At this point I fear you are not really engaging with (or even reading) the post. If you have specific criticisms, I'm happy to address them. If not, then I probably cannot help very much.
Here's one example - I suggest it only needs to be in somewhere near the right ballpark to have a significant impact.
We don't know how many legal abortions there are in India each year, because they don't keep good statistics. But suppose the rate is similar to most other countries with legal abortion - this would be about 4 million abortions a year. If, as I suggest, prohibition of abortion prevents at least half of abortions, then for every year you delay the legalisation of abortion, that would be at least 2 million lives saved. Given how neglected the topic is politically in many countries like India (on the pro-life side, at least), I think you could have delayed the legalisation of abortion by at least a month with a team of 10 people working full time for, say, a year. That's perhaps £100,000 - and would have saved ~170k lives.
Again, this is pretty speculative, but if it is anywhere near the right ballpark, then it looks pretty compelling in terms of cost-effectiveness.
There are lots of survey-based studies on abortion in countries where abortion is illegal - the problem is not so much getting it through an ethics board as the reliability of the results. You could alternatively measure using hospitalisations for incomplete abortion as a proxy - you won't be able to identify the exact magnitude of the problem or the change since an unknown proportion of these are from miscarriages (some have tried to estimate the 'natural' miscarriage presentation rate, but I think these estimates are obviously unreliable), but you could see if there is a change and whether it is a big or small change, since the miscarriage rate should remain relatively constant. It would need a big enough sample size though.
Yes, Marston and Cleland's paper is helpful, I think. But I think developing countries are generally most likely to have risk compensation, since they tend to be more conservative sexually and thus have more capacity for increased risky sex. The countries where abortion and contraception are inversely correlated tend to be those which have already been through a kind of sexual revolution, and were using abortion as birth control (i.e. generally the Soviet bloc in the latter 20th century). But neither of those are true in most developing countries today.
Thanks for this. I have had an (admittedly short) scout around, and would be grateful for a bit more direction if possible. Both Lafiya and FEM seem to take women reached and contraceptive prevalence as their primary measured outcome - but this doesn't get us what we need, since contraceptive prevalence can have both positive and negative effects on the abortion rate (due to risk compensation). Do you know if either have an RCT where they measure pregnancies (or, even better, abortions) as an outcome? If so, do you know where I could find this?
Sure - but this is why I included the section on offsetting for women, wherein I noted that the empirical evidence just doesn't support the idea that reducing abortion causes comparable harm to adults.
Perhaps, but there are many ideas EAs believe in which come across as prima facie implausible to some people - this is why I gave arguments (with links for more detail) to suppose that human embryos have similar moral value to adult humans - so it is difficult to respond without knowing exactly where you think those arguments go wrong. Could you elaborate please?
Perhaps - though this is only a somewhat peripheral and unnecessary part of my argument - most of which depends on the idea that they do indeed have some value. There will be some EAs who do hold views with pronatalist implications - this argument should be quite powerful for them. Other EAs don't hold such views - that's fine.
As I noted in the post, it is not neglected in the USA, though it is neglected in certain sectors, and is extremely neglected outside the USA (and to an extent Latin America).
I know some that plausibly save tens or hundreds of thousands of lives a year on a very low budget, but they are quite low-key so it is hard to say more.
Highlighting the passage is perfectly fine - I wrote it, and it is part of the post. What is not fine is continually suggesting that it is the primary argument I have given for abortion being wrong, when that is manifestly not the case, and I have made that explicit. I'm happy to respond to criticisms of that particular point - but not for people to misrepresent my post by pretending that it is the main argument given, especially when I have clarified that it is not.
Yes, I am familiar with the evidence. If I had deliberately misrepresented any of the papers I cited, then again, you would be right. But you have failed to show that. Bockmann does think the fetus is likely conscious and able to feel pain by that point, even if they phrased it more hesitantly in the paper, presumably because it is difficult to be certain. Of course, we can never be certain - but they have shown that the main arguments for placing fetal consciousness later in pregnancy fail. I see no good reason to suppose it is later than 12 weeks.
Again, no, I did not 'just state' that we should 'assume' 4 week old fetuses have full human rights. I said, for example, "Denial of fetal personhood typically leads to implausible conclusions regarding how we may treat infants and severely disabled humans, and arguably to a denial of human equality even among non-disabled adults." These arguments apply to all embryos/fetuses, regardless of whether they can feel pain, and more detail is available in the references linked.
Thanks Nick. I have come across quite a lot of abortion surveys in countries with restrictive laws. Here is one from Uganda: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0002340#sec007 I agree entirely that the results are likely not to be very reliable, but I think that is the bigger problem; less so the lack of ethics approval.
"Long science comment incoming: I’ve had some time to go over the literature, and I find the passage below (which is the main secular argument against abortion presented) to be highly misleading."
As I already explained in my comments above, the paragraph to which you refer was not the main argument against abortion, it was an extra peripheral consideration for a certain subgroup of readers. I do not understand why you seek to misrepresent my post even after I made this clarification.
"The mature brain cortex does not appear until week 24-ish, and according to this review paper , EEG results only produce reliable patterns synonymous with “wakefulness” at week 30, and at earlier dates the signal is often discontinuous. However, there is some research showing that cognition and experiences can occur without a fully formed cortex, so it should not be taken as the dividing line for certain.
(If you think I am cherry picking, these sources come from the first google scholar results for "fetal pain review")"
Yes, Lee's paper is well-known. But the wakefulness stuff is not really plausible - the RCOG dropped the argument completely from their recent review of the evidence, as Bellieni's recent response points out (https://onlinelibrary.wiley.com/doi/10.1002/ejp.2109) - as Derbyshire pointed out elsewhere, there are a number of problems with this argument, including the fact that we just don't really know much about the EEG sleep patterns even for newborns, let alone fetuses. We also have pretty clear ultrasonography from 23 weeks showing a fetus clearly crying in response to an anaesthetic injection - it is very implausible to me that this is done while asleep.
Regarding the rest: yes, the authors are somewhat cautious, though I'm pretty sure Bockmann now considers it likely the fetus can feel pain from 12 weeks, and I think is open to it being even earlier. The question is: is there any reason why the fetus wouldn't feel pain at that point? You might say 'because the cortex isn't fully developed'. But as the authors point out, there is reason to doubt the necessity of the cortex for pain perception. The wakefulness argument doesn't really work, for the reasons that Bellieni and Derbyshire describe.
"What the OP also didn’t mention was what the whole debate was mainly about: whether or not to use analgesia or anaesthesia when performing abortions. Even if an early fetus is capable of feeling pain, the use of these during the abortion may render the procedure painless."
No, this isn't what the debate is mainly about. I have made very clear in my comments I am also talking about early embryos/fetuses before pain capability, and that the arguments I describe briefly (and link to for more detail) apply to these.
Here's one example - I suggest it only needs to be in somewhere near the right ballpark to have a significant impact.
We don't know how many legal abortions there are in India each year, because they don't keep good statistics. But suppose the rate is similar to most other countries with legal abortion - this would be about 4 million abortions a year. If, as I suggest, prohibition of abortion prevents at least half of abortions, then for every year you delay the legalisation of abortion, that would be at least 2 million lives saved. Given how neglected the topic is politically in many countries like India (on the pro-life side, at least), I think you could have delayed the legalisation of abortion by at least a month with a team of 10 people working full time for, say, a year. That's perhaps £100,000 - and would have saved ~170k lives.
Again, this is pretty speculative, but if it is anywhere near the right ballpark, then it looks pretty compelling in terms of cost-effectiveness.
There are lots of survey-based studies on abortion in countries where abortion is illegal - the problem is not so much getting it through an ethics board as the reliability of the results. You could alternatively measure using hospitalisations for incomplete abortion as a proxy - you won't be able to identify the exact magnitude of the problem or the change since an unknown proportion of these are from miscarriages (some have tried to estimate the 'natural' miscarriage presentation rate, but I think these estimates are obviously unreliable), but you could see if there is a change and whether it is a big or small change, since the miscarriage rate should remain relatively constant. It would need a big enough sample size though.
Yes, Marston and Cleland's paper is helpful, I think. But I think developing countries are generally most likely to have risk compensation, since they tend to be more conservative sexually and thus have more capacity for increased risky sex. The countries where abortion and contraception are inversely correlated tend to be those which have already been through a kind of sexual revolution, and were using abortion as birth control (i.e. generally the Soviet bloc in the latter 20th century). But neither of those are true in most developing countries today.
Thanks for this. I have had an (admittedly short) scout around, and would be grateful for a bit more direction if possible. Both Lafiya and FEM seem to take women reached and contraceptive prevalence as their primary measured outcome - but this doesn't get us what we need, since contraceptive prevalence can have both positive and negative effects on the abortion rate (due to risk compensation). Do you know if either have an RCT where they measure pregnancies (or, even better, abortions) as an outcome? If so, do you know where I could find this?
Thank you for your comments. To try and respond:
Thanks again for your comments.