Concept of personhood

Jacqueline Calleja (February 7) gives me credit for the concept of personhood, based on the possession of mental faculties, although she is undoubtedly aware that this is the view of most modern secular bioethicists.

In modern rights-based societies, from the moment of birth and throughout life, the question of personhood does not arise and all human beings are considered legal and moral persons with legal and moral rights, until death. Whether they are children with a low IQ or adults with senile dementia, no reason to question their status exists and society makes no distinction between one citizen and another.

Even a neonate, who does not yet have self-awareness and, as a result, interests, has its rights held in trust for it by society and, should its parents not wish to look after it, other adults willing to fill their shoes could easily be located. The same applies to babies who survive premature birth or intentional abortion.

Patients in a persistent vegetative state present an ethical minefield, as there are those who believe that these patients should be allowed to die and others who hold that they should be kept alive at all costs. Several court cases involving such patients have cited considerations such as the quality of life, the wishes of family members, the use of hospital resources and professional responsibilities to reach a decision.

The case of the unborn child is markedly different. In this situation, the viability of the foetus is directly dependent on the pregnant woman, not on society. Although this presents no problem should the woman wish to take her pregnancy to completion, it becomes the subject of ethical consideration if the pregnancy is unwanted.

In this scenario, many bioethicists believe that the moral rights of the foetus, which on the basis of its mental development has not attained the status of personhood, are overridden by the full moral rights of the woman. It is only with the wiring up of the cerebral cortex, which occurs between the 25th and 32nd week of gestation, that the foetus develops sentience and consciousness, thereby achieving the status of personhood.

In the US today, 98 per cent of abortions occur within the first 15 weeks of gestation and 99.9 per cent within the first 27 weeks. Third trimester abortions are rare and sought only because of a physical threat to the woman or gross abnormality of the foetus. In my opinion, abortion of the foetus for gross abnormality is only ethically justifiable in situations which are incompatible with life, such as anencephaly, or others with a low rate of survival and an extremely poor quality of life, such as trisomy 18, which has a 10 per cent first year survival rate and trisomy 13, which has a 28 per cent rate. Both conditions are accompanied by severe retardation, limb and organ deformities and a general inability to see, hear or smell.

On the other hand, spina bifida and Down's syndrome are both compatible with life and sufferers of these conditions may lead perfectly happy lives, once the appropriate surgical interventions have been undertaken.

Ms Calleja is entitled to her opinion and that of the contemporary Catholic Church that personhood occurs at conception. But she must concede that opinions vary. If she were Jewish, she would believe that life began at birth or, if she were a traditional Muslim, she would believe that ensoulment occurred at 120 days of gestation. Perhaps, had she lived in the 13th century, she would have agreed with Popes Innocent III and Gregory IX, that abortion is homicide only when the foetus is "formed".