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In the scientific perfection of killing, a change The face and image of RU-486 By Mary A. Nicholas
RU-486, however, cannot alter the abortion experience because what is common to both surgical and medical abortion is an act of violence which represents a personal experience for the mother. RU-486, though it may avoid a surgical invasion of her body, still reaches the most interior portion of a woman—her soul. There may be some aspects of its use that put a thicker screen between consciousness and the person, i.e., fragmentation of the act itself, and the attempt to portray RU-486 as a contraceptive. A possible miscalculation on the part of the designers, however, could have the opposite effect—seeing the embryo expelled—a sight which is often spared the woman who has a surgical abortion under anesthesia. The surgical act of abortion represents a cut both into the integrity of a woman’s body and into her consciousness as a person. First, “any instrumental abortion is an intrusion. Physically, it is an operation and may leave a scar.”3 Second, since a woman is a composite of body and soul, an effect in one is felt in the other. This important consequence was sensitively noted in Donum Vitae: “An intervention on the human body affects not only the tissues, the organs and their functions but also involves the person himself on different levels.”4 Even Etienne Baulieu admits “psychologically, it [abortion] is an invasion of the most intimate reaches of a woman’s body.”5 A. Experience of the body Within the context of RU-486, it is significant that women state they would choose a chemical abortifacient in preference to surgery which from ancient times has always been considered destructive of the body’s integrity. In this statement, perhaps without any formal training in metaphysics, they are expressing something about their own experience of being. For their first experience of being (though they do not remember) began in their mother’s womb.
These first movements of the body, though we may not want to label them “conscious” are personal, and individual, hidden even from the mother. What the fetus can do at five to nine weeks, the mother only feels at 15 to 21 weeks. One of a person’s first conscious discoveries is that he/she has a body. However “the person is not to be identified solely with the body as such.”7 Man is not the body, “he only has it. Man has his body in a special way and also in a special way he is aware of his possession . . . . ”8 In explaining the relationship between the conscious subject and the body, Wojtyla refers to Luijpen’s remarks that : “I neither ‘am’ my body nor ‘have’ it.”9 This fundamental perspective, that man is not the body, can be seen in the Yahwist text of Genesis which never speaks directly of the body. “Even when it says that ‘the Lord God formed man of dust from the ground,’ it speaks of man and not of his body.”10 There is no word for body, per se, in the Old Testament. The closest approximation to a Western scientific notion of human “body” is basar, which is more properly translated flesh, and only secondarily body. Neither is this term sufficient by itself. One would have to include nephesh which means the entire expression of the person.11 This absence of a specific word for “body” is perhaps one of the most significant statements about the body in the Old Testament. There is no separate word for man’s body, since the body was considered an exterior manifestation of the personality. One of the assumptions about RU-486 is that this type of abortion will leave less of a scar on a woman since it does not involve a surgical procedure. Referring back to the meanings of the Hebrew word, nephesh, we can see that this cannot be the case. For, one of the very fundamental meanings for nephesh is, in fact, throat, the part of the body involved in taking a pill, as when Jonah cries in anguish: “The waters closed in over my nephesh” (Jon. 2:5). And, as indicated previously, nephesh refers to the living self, the living being. An invasion of the throat, aimed at another in the womb, is no less an invasion of the body than an instrumental abortion. According to John Paul II, the text: “flesh of my flesh and bone of my bones,” (Gen. 2:23) takes on the meaning: the body reveals man. This concise formula “already contains everything that human science could ever say about the structure of the body as organism, about its vitality, and its particular sexual physiology, etc.”12 “We cannot discuss the human body apart from the whole that is man, that is, without recognizing that he is a person,”13 summarizes John Paul II’s anthropology. Significantly, John Paul II uses the word possession to express the relationship of man to his body. This conveys a very different meaning from ownership, which signifies a rightful claim to something.14 By contrast, Margaret Sanger specifically used the word own with respect to women’s bodies: “No woman can call herself free who does not own and control her body.”15 A further distinction that John Paul clarifies, however, is that man’s knowledge of his body includes the meaning of his body: “It can be affirmed with certainty that man, thus formed, has at the same time consciousness and awareness of the meaning of his own body. The original description of human consciousness given in the Yahwist text also comprises the body; it contains “the first testimony of the discovery of one’s corporality” (and even, as has been said, the perception of the meaning of one’s own body) revealed on the basis of a “concrete subjectivity of man . . . .”16 The body, for John Paul II is:
B. Experience with RU-486 Those who have the worst experiences with RU-486 are those who see—not the image of RU-486—but the face, i.e., those who are able to see the fetus. “Others do not abort quickly, but spend days, cramping, bleeding and feeling uncomfortable, not knowing when it will be over. Some are disturbed by the sight of what comes out of them—a sac that is generally ruptured in a surgical abortion.”18 One doctor involved in the RU-486 trials admitted the experience can be difficult: “We’ve had a few patients who’ve been somewhat shocked at the tissue they passed, at seeing the little bubble there, the sac and placenta,” said Dr. Judy Tyson, the medical director of Planned Parenthood of Northern New England, who supervised the Vermont mifepristone trial. “Some women don’t want to know about it.”19 C. Fragmentation of the act The typical protocols for RU-486 call for three to four visits to a clinic which are described as follows: 1. a visit for diagnosis of pregnancy and deciding for VIP (voluntary interruption of pregnancy); 2. after a week of reflection (required in France) a second visit to take the RU-486 pills; 3. a third visit, 48 hours later, to receive a small amount of prostaglandin in the form of a synthetic derivative, and 4. a final visit to verify the completeness of the process.20 Depending on the stage of pregnancy the embryo could be dislodged after the first, second, or third visit. Compared to a surgical act, this fragmentation will blur the act of the abortion. When did it occur? Yet, to those promoting RU-486, a distinct moment to define the time of abortion does not appear to be important. “If indeed most women feel that the decisive moment occurs when they take the RU-486 pills, the rest of the process may be perceived as a denouement, even if it is fraught with some uncertainty.” 21 D. Euphemisms Cook and Grimes in their analysis of antiprogestin drugs, describe the use of RU-486 as a postcoital contraceptive. Its use, they assert, will prevent unwanted pregnancy and “reduce the incidence of abortion.”22 The Reproductive Health Technologies Project (U.S.) in another example of linguistic distortion, predicts that the abortion pill will have “a life-saving potential in developing countries . . . .”23 A final example of attempting to mask the abortifacient character of RU-486 is the use of the phrase, “inducing a miscarriage,”24 to refer to its use. One of the most dangerous aspects of RU-486, however, is the use of the language of contraception to change the image of the drug. Referring to RU-486’s ability to retard the formation of a secretory endometrium, promoters state: “Pregnancies are thereby averted because implantation is prevented.”25 This is a clear misstatement of accepted medical science which defines pregnancy as: “The condition of having a developing embryo or fetus in the body, after union of an ovum and spermatozoan.”26 Proponents of RU-486 are aware of the potential involved in these misrepresentations. Baulieu noted that “The American press made little distinction between contraception and abortion, let alone contragestion.”27 Other researchers have remarked: “The use of RU-486 to prevent abortion rather than to cause it challenges both proponents and opponents of availability of the drug, because its postcoital contraceptive use would serve a significantly greater number of women than its use for abortion.”28 This is illustrated in a study where
Clearly it did not escape manufacturers that “an abortion pill” would be associated with the contraceptive pill, commonly referred to as “the pill.” The phrase “abortion pill” would soon be used interchangeably with “the pill” and the distinction between contraception and abortion blurred. Evidence leads one to conclude that this attempt at equating contraception and abortion must be part of the strategy, as evidenced from the literature: “Use of RU-486/prostaglandin as a postcoital contraceptive could take the method out from under the regulation of abortion, depending upon how the law defines abortion.”30 “The method may also be used effectively without first testing for pregnancy although if the woman is not pregnant, she may be undergoing an unnecessary medical procedure.”31 A last example is perhaps the most illustrative of this mentality. In 1990 David A. Grimes and Daniel R. Mishell carried out a clinical trial of RU-486 at the Los Angeles Country Women’s Hospital.
This study represents the ultimate experiment in violence which Levinas states “does not consist so much in injuring and annihilating persons as in interrupting their continuity, making them play roles in which they no longer recognize themselves, making them betray not only commitments but their own substance, making them carry out actions that will destroy every possibility for action.”33 This experiment mutilated not only an early human being, but the experience of the abortion to the woman—will she know whether she has killed her baby? This is a monstrous order, described by Marcel: “where murder seems to be so easy, so indiscernible, so tempting, that it is not even recognized as such by him who accomplishes it.”34 E. Experience with abortion: Reported and real In spite of the growing literature on the post-abortion stress syndrome35 and personal experiences with patients, proponents of RU-486 speak of this abortifacient as a more natural, better abortion experience. “And two hours after taking the second round of pills, after 15 minutes of intense cramping, the tiny sac the doctors call the ‘products of conception’ passed out of her, and relief washed her face. ‘I feel like my old self again,’ she said happily, holding hands with her boyfriend, ‘I’ve never had a surgical abortion, so I can’t compare, but this seems more natural, more like how your body would have a natural miscarriage.’”36 Another West Coast woman said, “I’ve had two surgical abortions, and this is a much better, less invasive, more natural method . . . .”37 Comparing RU-486 with surgical abortion, a woman said: “I’d had a really bad experience with an abortion when I was 23 . . . . It wasn’t complete, so I had to have it redone, and then my cervix didn’t close. I dreaded another one. But I had an accident with a condom . . . I felt fine after the first set of pills,” she said, “I went back and took the second pills, and almost right away, in 20 minutes, I was extremely nauseous. I never really had any pain, but within an hour, I’d passed it. I just thought it was a blood blob, until the nurse told me that was it . . . . It’s very different from an abortion where they put something inside your body, and there’s loud noises and sucking and scraping. I can’t say strongly enough how much better this is.”38 I would like to cite some personal experiences with patients after surgical abortion. They are images and faces of women I have treated. They represent real persons and real situations in various clinics. For each of them, abortion was a direct and personal experience. Sometimes a reference to abortion came in the form of a quiet whisper, almost an afterthought, from a woman who had suffered with the results of abortion for more than 20 years. In other cases it came in the form of a louder cry of admission. In each case it came from the voice of a “she,” not an “it” of a manufactured statistic. These women were patients and I was their physician. They were not “subjects” in a randomized, controlled double-blind experiment, ticking off boxes on an impersonal questionnaire or interviewed by a “non-biased” observer. For the sake of confidentiality, exact quotations have been deleted. A 26-year-old female complained of pain in the abdomen for two weeks. She had been to see a gynecologist the day before. On physical examination, there were no objective findings other than a small lymph node noted in the groin. Further discussion revealed that the pain had started on the day of her daughter’s confirmation. When asked if she had any other children, she replied that she had one abortion before the birth of her child and one after. This was not an uncommon finding: physical symptoms began or recurred on religious days of significance or anniversary days of the abortion. A thirty-year-old female with a history of depression, alcohol and drug abuse, complained of a sore body for several months, with a pain on the right side. She said she “felt pregnant.” When asked if there were any possibility that she could be pregnant, she said no, her tubes had been tied, cut, and “burnt” nine years before. Physical examination showed pain in the groin diffusely and in the abdomen. Further history revealed that she had been pregnant nine times, had one miscarriage, six abortions, and two children. Again, what was a common finding was that a scar was left “interiorly” in the body in the general location, e.g., right-sided abdominal pain where previous surgery had taken place, whether it was a tuboligation or abortion. Another patient presented to the clinic with non-localized abdominal pain. When asked if she had ever been pregnant, she replied no. When asked if she had ever had a miscarriage (this would be part of a normal gynecologic history) she also said no. Questioning whether she had ever had an abortion, the reply was five. What was notable about these reactions was that all were expressed in an impersonal sense. There was rarely any verbal recognition of a child lost in the sense of “flesh of my flesh.” In all, there was in fact a notable detachment of themselves and their histories from their bodies. Each of these patient’s experiences was unique, personal and painful. The one whose face was not yet formed—but who was not faceless—spoke silently on her face. Their stories contrast markedly with the experiences they should have had according to the promoters of abortion and RU-486. Promoters want to not only dispose of the child but also the experience of having destroyed the child. But experience cannot, like a pill, be manufactured or swallowed. It is, above all, personal. “The experience had from the inside is only possible in relation to the man who is myself, . . . this inner experience can never be had in relation to any man but myself.”39 Thus, there is a disparity of reactions even among women after RU-486: “I feel like my old self again,”40 contrasts with “I took the decisive action, I killed the child, there were no intermediaries.”41 Is this, on a spiritual level, what St. Paul meant when he said: “Among human beings, who knows what pertains to a person except the spirit of the person that is within” (1 Cor. 2:11). Conclusions The global, scientific attempt to contracept consciousness, so different from the personal experiences cited and faces observed, interferes in the most critical function of man’s consciousness which is “to form man’s experience and thus to allow him to experience in a special way his own subjectiveness.”42 Consciousness is “an intrinsic and constitutive aspect of the dynamic structure”43 of the human person, as constitutive as flesh and bones. This attempt at the mass-production of experience, to produce a collective consciousness, especially with these vulnerable women, is perhaps more violent than the mutilation of flesh. In the scientific perfection of killing, a change of abortion technique will not change the experience of abortion for the woman because women, by nature, have a “meta-technical” sphere of “being to which techniques are never able to gain access.”44 “In the most noble part of the soul, the domain of our spiritual powers, we are constituted in the form of a living and eternal mirror of God; we bear in it the imprint of his eternal image and no other image can enter there.”45 RU-486 will not change the experience of abortion for the woman because the foundation of her experience of being is a personal experience of her body. Integral to this experience of her body, she has a consciousness and awareness of the meaning of her body, the meaning of her womb—to carry (gestare), which also sheds light on the meaning of the molecule, progesterone.
Mary A. Nicholas, M.D., has worked as an emergency room physician and physician in family clinics. At present she is a researcher on bio-ethical issues and a graduate student at the John Paul II Institute in Washington, D.C. She is knowledgeable on the following ethical issues: in vitro fertilization, population, fetal research, abortion, RU-486, natural family planning, contraception, partial-birth abortion and euthanasia. This is her first article in HPR. |