The abortion debate in the United States has almost exclusively focused on questions of rights, to the exclusion of all other considerations. A consequentialist approach that assesses the morality of abortion in light of its good and bad consequences has the potential to resolve the rights standoff, and a number of consequentialist considerations have bearing on the abortion debate. Abortion critics have long raised fears of a slippery slope, charging that permissiveness about abortion will inevitably lead to the devaluation of human life, and a "culture of death" in which attitudes about other forms of killing, such as infanticide and euthanasia, will become more permissive. The argument depends on the assumption that the killing of a fetus is regarded as just as serious as the killing of an infant, child, or adult, and that the permissibility of one entails the permissibility of all. The culture of death argument, like other slippery slope arguments, also makes an empirical claim that the evidence to date fails to support. Since abortion was legalized in the United States in 1973, there has been no slide toward permissiveness about other forms of killing. Only one state, Oregon, has legalized physician-assisted suicide, under strict regulation. In all other states that have considered physician-assisted suicide or euthanasia, voters have declined to endorse it. Neither is there evidence to suggest that the killing of newborns is more common in the United States than it was before abortion was legalized, but in parts of the world where infanticide has historically been an acceptable means of eliminating unwanted offspring, the availability of abortion has not increased the incidence of infanticide, but reduced it (Kristof).
The coat hanger has been a powerful symbol of the abortion rights movement, a reminder of the dangerous, sometimes deadly abortions women endured before Roe v. Wade. Proponents of abortion rights have substantial evidence to support the claim that legal prohibitions on abortion lead to the deaths of women through self-induced abortions or illegal, unsafe abortions performed by untrained providers. Legal abortion performed under safe and sanitary conditions is generally safer than pregnancy, but in countries where abortion is prohibited, or access is severely limited, the negative consequences of unsafe and self-induced abortions include serious complications such as sepsis, hemorrhage, genital and abdominal trauma, perforated uterus, gangrene, secondary infertility, permanent disability, and death (World Health Organization [WHO]). Treatment of complications from unsafe abortions places a serious strain on the medical infrastructure of developing countries, where a disproportionate share—up to 50 percent—of scarce hospital resources are expended treating abortion complications. Unsafe abortions thus compromise other maternity and emergency health services in poor countries where healthcare is already inadequately resourced (WHO). Statistics on abortion-related mortality are especially telling: In Paraguay, illegal abortions are responsible for an astonishing 23 out of every 100 deaths of young women (United Nations). In Romania, abortion-related deaths increased sharply after 1966, when the government restricted abortion. The maternal death rate rose from 20 per 100,000 live births in 1965 to 150 per 100,000 in 1983. Abortion-related deaths decreased by more than 50 percent in the year after abortion was again legalized in 1989 (WHO). Statistics on abortion-related mortality in the United States tell a very different story about safe, legal abortion: the death rate is 0.6 per 100,000 procedures, making it as safe as a penicillin injection (WHO).
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