Psychological Research on Abortion and its Dubious Influence on Policy Makers

1. Psychological Research on Abortion and its Dubious Influence on Policy Makers Myretha McInnis November 8th

2. Overview • Relevant philosophical views on abortion • The state of abortion in the Canadian legal system • Some relevant psychology research • The debate on morals and psychological research • Definition – the term ‘abortion’ will refer to only induced abortions and not spontaneous abortions in this presentation

3. Philosophy and Abortion • the moral status of the fetus • Sumner (1974) • Conservative view on abortion - the fetus is a human being thus abortion is the moral equivalent of murder and should therefore never be accepted unless the life of the mother is in danger. • Liberalist view of abortion - the fetus has no moral value, therefore the question of abortion has no moral value. Abortion is acceptable unless it puts the woman in danger. • Moderate view - the fetus only has moral value after it develops and central nervous system (allowing for sensations of pain) and a brain. Therefore, anytime before this development an abortion should be permissible and anytime after this development, an abortion should not be allowed.

4. Philosophy and Abortion con’t • Sherwin (1991) - an account of the feminist perspective. • The three above mentioned views on abortion are incomplete because they ignore the pregnant woman as an active member of the relationship. She is opposed to the tendency of these discussions to see the pregnant woman as being a passive vessel for the fetus • The moral status of the fetus is irrelevant. • Only the pregnant woman can know if the fetus she carries should be brought to term or terminated because she is the only person who can know her situation. • Conservative view of abortion is typically referred to as the pro-life position • Liberalist, moderate and feminist views are often considered pro-choice position on abortion.

5. Abortion and the Law • 1988 - abortion was completely removed from Canadian criminal law. (M. Ramsay, personal communication, November 11, 2005) • It is not illegal for women in Canada to receive an abortion • She also does not have a right to an abortion • Women in Canada can receive an abortion at any time during her pregnancy. • Because there is no right to an abortion in Canada, hospitals do not have to ensure that they staff a doctor who will perform abortions. • Provinces are not required to fund any abortions

6. The cost for an abortion at a Morgentaler private clinic can cost anywhere from $300 to $900 (Morgentaler, 1998). • Not all provinces have private clinics for abortions. • Most are located in large cities, not in rural areas, this limits access to abortions for some (i.e. the poor who live in rural areas) and not for others. • The Canadian health Act requires that Canadian citizens should have equal access to health care procedures (Government of Canada, Canada Health Act) • Therefore some standard must be agreed upon by the federal government in order to insure equal treatment of all women regarding abortion policies.

7. Psychological research on Abortion Nordal Broen, et al (2005) • Emotional distress after an abortion (10 days, 6 moths, and 2 years after their abortions) N= 80 – Location, Norway. • Researchers related the emotional distress of women at these times to the reasons women give for having an abortion. • Strongest relationship to a negative outcome for women was reporting the reason for abortion as “pressure from male partner” similarly the reason “male does not want a child at the moment” was also strongly correlated to negative effects. • This research implies that outcomes of abortion may be linked to issues besides the abortion itself • What issues might be linked to these findings other then the abortion?

8. State-funded abortions versus deliveries: A comparison of outpatient mental health claims over 4 years (Coleman et al. 2002) • N = 249,625 – Location, California • A comparison of abortions and live births on participants mental health. • First time mental health claims with diagnosis of one or more of the following; • adjustment reactions, depression, bipolar disorder, anxiety, non-organic psychoses, alcohol and drug abuse, psychalgia, acute stress reactions and schizophrenia. • Women who have a history of abortion have a significantly higher rate of first time outpatient treatment then women who gave birth. (this is true, 90 days, 180 days, 1 year, and 2 years after the target event, but there was no significance after the 3rd and 4th years). • Diagnosis that were found to be significant were; adjustment reaction, bipolar disorder, neurotic depression, and schizophrenic disorder. • Implications – a woman found to have one of the above diagnosis might be part of a population that is more prone to negative adjustment after an abortion.

9. ‘Violence in the lives of women having abortions: implications for practice and policy’ (Felipe Russo, & Denious, 2001) • N= 2,525 – Location, USA • Question; Is there a relation of increased violence in the lives of women who have abortions? Even when variables are controlled? • Other variables include: race (white v. other women), income, education, marital status, and parental status (i.e. having children under the age of 18 living in the home) • Violence variables include: childhood physical and sexual abuse, partner violence, and rape. • Abortion is related to increased violence • These women are more likely to have partners who refuse to were condoms • Abortion is related to psychological distress (such as suicide ideation, anxiety or depression and lower life satisfaction). • Once variables such as race, education, having a violent partner, a history of physical or sexual abuse and/or a history of rape and sexual assault were controlled for, abortion was no longer correlated with psychological distress

10. Born Unwanted: Observations from the Prague study (David, Dytrych, & Matejcek, 2003) • N= 220 pairs – location – Prague (Czech Republic) • Unwanted pregnancy = mother applied to have an abortion and was denied • ‘unwanted pregnancy’ (UP) in a longitudinal study (birth to age 35). • Includes a group of children who were accepted- pregnancies (AP). These AP were pair-matched with the UP children. • UP and AP children were compared with their siblings at follow ups 4 and 5 (ages 30 and 35 respectively). • Age 30 (1992-1993) - UP adults were found to have less favorable psychosocial adaptations then the AP adults. • Siblings of the UP children had lower scores on scales such as lower scores on social integration scales (based on, absence from criminality, and alcohol abuse, etc.) • There were non-shared effects among males siblings as well, such as on anxiety and depression scales (UP child scored similarly to their sibling and to AP males). In females however, the reverse was found. • Age 35 (1996-1997) – UP adults were found to have become psychiatric patients more often then both the AP adults and their siblings. UP adults and their siblings were found to be under-socialized in comparison to the AP adults and their siblings.

11. From the limited research available on children who are born unwanted and are raised by their birth mothers, it would seem that there are negative outcomes for these children when compared to children of accepted pregnancies and when compared to their own siblings on some measures. However, there are similarities in the scores of UP adults and their siblings that indicate a common environmental effect on their development.

12. In general psychological research seems to indicate that the negative effects often seen after a woman has an abortion may be due to other factors such as; abuse, being coerced into having an abortion, or preexisting dispositions that make it more likely for them to suffer from negative diagnosis (i.e. depression).

13. Implications of psychological research for public policy makers Any Guesses?

14. Psychology and the Ethics of Social Policy (Kendler, 1993) • Because of the empirical nature of most psychological research, it can not be used to guide moral debates. • Kendler writes that even when a moral question seems to be ‘proven’ by research, it is not. Research can not prove a moral to be right or wrong. • An example: evidence supporting the benefits of segregating children on the bases of language – even though their test scores may go up when segregated this does not ‘prove’ that children SHOULD be segregated. This is a moral question. • Kendler makes a distinction between better and good. • Applied to the topic of abortion- it may be better for woman if she is given complete say over her reproduction, but the question of whether that is good or not can not be answered with empirical research

15. It is stated in the Canadian Code of Ethics (IV)- researchers have a responsibility to society. • it can be assumed that it was this principle that Felipe Russo and Denious were appealing to when they wrote the section “implications for public policy” in their study.

16. Graduate Studies • Marc Ramsay Ph.D. Acadia University Interests include: Ethics and philosophy of law, including constitutional rights and judicial review, children's rights, philosophical issues in the private law, and theories of equality. • Ishtiyaque H. Haji Ph.D. University of Calgary Interests include: Ethical theory, action theory, philosophical psychology, free will and moral responsibility. • Elizabeth E. Brake Ph.D. University of Calgary Interests include: Ethics, political philosophy, and feminist philosophy.

17. References Coleman, P.K., Reardon, D.C., Rue, V.M., & Cougle, J. (2002). State-funded abortions versus deliveries: A comparison of outpatient mental health claims over four years. American journal of orthopsychiatry, 72 (1), 141-152. David, H.P., Dytrych, Z., & Matejcek, Z. (2003). Born unwanted: Observations from the Prague study. American psychologist, 58 (3), 224-229. Felipe Russo, N., & Denious, J.E. (2001). Violence in the lives of women having abortions: Implications for practice and Public Policy. Professional psychology: Research and practice, 32 (2), 142-150. Government of Canada, Canada Health Act. In E.H.W. Kluge (Ed.) Readings in biomedical ethics: A Canadian focus (3rd ed.). (pp. 52-57). Toronto, Ontario: Pearson. Kendler, H.H. (1993). Psychology and the ethics of social policy. American psychologist, 48 (10), 1046-1053.

18. Morgentaler, H. 1998, The Morgentaler Clinic. Retrieved November 3, 2005, from http://morgentaler.ca/morgentaler.htm Nordal Broen, A., Moum, T., Sejersted Bödtker, A., & Ekeberg, Ö. (2005). Reasons for induced abortion and their relation to women’s emotional distress: a prospective, two-year follow-up study. General hospital psychiatry, 27, 36-43. Sherwin, S. (1991). Abortion through a feminist ethics lens. In E.H.W. Kluge (Ed.) Readings in biomedical ethics: A Canadian focus (3rd ed.). (pp. 339 – 352). Toronto, Ontario: Pearson. Sumner, L.W. (1974). Toward a credible view of abortion. In E.H.W. Kluge (Ed.), Readings in biomedical ethics: A Canadian focus (3rd ed.). (pp. 324-339). Toronto, Ontario: Pearson.